Cenata Alexandria Jackson
Behavior Technician in Richmond, VA. Individual provider (NPI-1).
NPI number1982203139
StatusActive
Last updated in NPPESOct 20, 2020
Details
- NPI
- 1982203139
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Cenata Alexandria Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 20, 2020
- Certification date
- Oct 19, 2020
- Last updated
- Oct 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
7353 Whitepine Rd Bldg GRichmond, VA 23237-2260
Phone 910-641-1389
Mailing address
3990 Resting PlPowhatan, VA 23139-6959
Phone 910-641-1389
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