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1710726930
LATRISSE N JACKSON
STOCKBRIDGE, GA
NPI
1710726930
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-05-20
Last Update Date
2024-06-04
Business Address
LATRISSE N JACKSON
137 SPINDLETOP WAY # 137
STOCKBRIDGE, GA 30281-7221
Phone number: 631-530-3900
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Mailing Address
LATRISSE N JACKSON
137 SPINDLETOP WAY # 137
STOCKBRIDGE, GA 30281-7221
Phone number: 631-530-3900
Copy
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