Brionka Jackson, RBT
Behavior Technician in Powder Springs, GA. Individual provider (NPI-1).
NPI number1386392256
StatusActive
Last updated in NPPESMar 10, 2022
Details
- NPI
- 1386392256
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Brionka Jackson
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 10, 2022
- Certification date
- Feb 22, 2022
- Last updated
- Mar 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | 22-204210 | GA | Yes |
Practice location
4080 Vine Ridge DrPowder Springs, GA 30127-1788
Phone 770-763-8592
Mailing address
4080 Vine Ridge DrPowder Springs, GA 30127-1788
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