Jackson, Jeremy

Jackson, Jeremy is an individual health care provider with primary practice located at 2185 Normandie Dr , Montgomery AL 36111-2728. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Jackson, Jeremy can be contacted via phone (334) 202-4638.

Contact Information

Primary practice address
2185 Normandie Dr Montgomery AL 36111-2728
Phone: (334) 202-4638
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X 19-97334 Alabama
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-19-97334

Profile Details

NPI number 1295383891
LBN Legal business name Jackson, Jeremy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2019
Last updated Jul 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295383891 NPPES
Georgia Other RBT-19-97334 RBT
Georgia Other RBT-19-97334 RBT

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