Most Relevant Information
Provider Data
| NPI Number: | 1003256603 |
| Provider Name: | LAURA E JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/27/2013 |
| Last Updated: | 06/27/2013 |
Provider Practice Location
2615 N PRICKETT RD
SUITE 10
BRYANT
AR
720227523
Practice Location Phone/Fax
| Phone: | 5018477337 |
| Fax: |
Provider Mailing Location
2615 N PRICKETT RD
SUITE 10
BRYANT
AR
720227523
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |