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1740782309
DARRIS DEKEITH JACKSON
BATON ROUGE, LA
NPI
1740782309
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: LA R2560)
Enumeration Date
2018-02-28
Last Update Date
2018-02-28
Business Address
DARRIS DEKEITH JACKSON
11606 SOUTHFORK AVE STE 300
BATON ROUGE, LA 70816-5238
Phone number: 225-292-5981
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Mailing Address
DARRIS DEKEITH JACKSON
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number:
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