Most Relevant Information
Provider Data
| NPI Number: | 1003392028 |
| Provider Name: | RENEE CAMILLE JACKSON BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 1-18-31297 |
Most Important Dates
| Enumeration Date: | 07/12/2018 |
| Last Updated: | 07/12/2018 |
Provider Practice Location
6515 HOLT RD
NASHVILLE
TN
372116903
Practice Location Phone/Fax
| Phone: | 6158320059 |
| Fax: |
Provider Mailing Location
4716 VENITO ST
MOUNT JULIET
TN
371224590
Provider Mailing Phone/Fax
| Phone: | 6782017111 |
| Fax: |