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1972180875
KENEISHA JACKSON
CHARLOTTE, NC
NPI
1972180875
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-03-26
Last Update Date
2021-03-26
Business Address
KENEISHA JACKSON
3000 LATROBE DR STE B
CHARLOTTE, NC 28211-5227
Phone number: 704-780-4271
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Mailing Address
KENEISHA JACKSON
1802 KOULTER DR
COLUMBIA, SC 29210-7420
Phone number: 803-509-1177
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