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1922713999
KANESHA JACKSON
LITTLE ROCK, AR
NPI
1922713999
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2023-01-13
Last Update Date
2024-04-03
Business Address
KANESHA JACKSON
20400 COLONEL GLENN RD
LITTLE ROCK, AR 72210-5323
Phone number: 501-821-5500
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Mailing Address
KANESHA JACKSON
20400 COLONEL GLENN RD
LITTLE ROCK, AR 72210-5323
Phone number: 501-821-5500
Copy
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