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1700472255
SHANIYA JACKSON
LOUISVILLE, KY
NPI
1700472255
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: KY RBT-20-146919)
Enumeration Date
2020-12-18
Last Update Date
2020-12-18
Business Address
SHANIYA JACKSON RBT
215 S HURSTBOURNE PKWY STE 213
LOUISVILLE, KY 40222-4937
Phone number: 502-353-2074
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Mailing Address
SHANIYA JACKSON RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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