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1568243897
MICHAEL L JACKSON
LOUISVILLE, KY
NPI
1568243897
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: RBT-23-286677)
Enumeration Date
2023-10-12
Last Update Date
2023-10-12
Business Address
MICHAEL L JACKSON RBT
175 MARKET PLACE DR STE A
LOUISVILLE, KY 40229-4471
Phone number: 502-251-7002
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Mailing Address
MICHAEL L JACKSON RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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