Most Relevant Information
Provider Data
| NPI Number: | 1003502261 |
| Provider Name: | JACKSON DANIEL SOSIN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2023 |
| Last Updated: | 04/12/2023 |
Provider Practice Location
1675 HICKORY LOOP
LAS CRUCES
NM
880056587
Practice Location Phone/Fax
| Phone: | 5756523155 |
| Fax: | 5054412871 |
Provider Mailing Location
301 PERKINS DR STE B
LAS CRUCES
NM
880053248
Provider Mailing Phone/Fax
| Phone: | 5756523155 |
| Fax: | 5054412871 |