Misty Ann Jackson
Day Training, Developmentally Disabled Services in Carpenter, WY. Individual provider (NPI-1).
NPI number1154239366
StatusActive
Last updated in NPPESAug 29, 2026
Details
- NPI
- 1154239366
- Entity type
- Individual (NPI-1)
- Name
- Misty Ann Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 29, 2026
- Certification date
- Aug 29, 2026
- Last updated
- Aug 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251C00000X | Day Training, Developmentally Disabled Services | – | WY | Yes |
Practice location
4022 S Cabot RdCarpenter, WY 82054-9611
Phone 307-287-0818
Mailing address
4022 S Cabot RdCarpenter, WY 82054-9611
Phone 307-287-0818
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