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1902497910
DESTINY JACKSON
JEFFERSONVILLE, IN
NPI
1902497910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: KY RBT-21-153699)
Enumeration Date
2021-02-02
Last Update Date
2021-02-02
Business Address
DESTINY JACKSON RBT
355 QUARTERMASTER CT
JEFFERSONVILLE, IN 47130-3670
Phone number: 812-258-9802
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Mailing Address
DESTINY JACKSON RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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