Most Relevant Information
Provider Data
| NPI Number: | 1003396797 |
| Provider Name: | AMARA-NIANI JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/21/2018 |
| Last Updated: | 08/21/2018 |
Provider Practice Location
6504 MOUNTAINDALE RD
THURMONT
MD
217882719
Practice Location Phone/Fax
| Phone: | 4432437647 |
| Fax: |
Provider Mailing Location
6504 MOUNTAINDALE RD
THURMONT
MD
217882719
Provider Mailing Phone/Fax
| Phone: | 4432437647 |
| Fax: |