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1699418582
CORDETTA LASHAWN JACKSON
SOUTHLAKE, TX
NPI
1699418582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: TX RBT-18-16039)
Enumeration Date
2022-04-18
Last Update Date
2022-04-18
Business Address
CORDETTA LASHAWN JACKSON
2104 GREENBRIAR DR
SOUTHLAKE, TX 76092-8355
Phone number: 817-442-9022
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Mailing Address
CORDETTA LASHAWN JACKSON
2104 GREENBRIAR DR
SOUTHLAKE, TX 76092-8355
Phone number:
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