Most Relevant Information
Provider Data
| NPI Number: | 1003597923 |
| Provider Name: | AYANA BEATRICE JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/25/2023 |
| Last Updated: | 07/25/2023 |
Provider Practice Location
9440 MARLBORO PIKE
SUITE 100
UPPER MARLBORO
MD
20772
Practice Location Phone/Fax
| Phone: | 8442441818 |
| Fax: |
Provider Mailing Location
1500 S DOUGLAS RD STE 230
CORAL GABLES
FL
331344108
Provider Mailing Phone/Fax
| Phone: | 8442441818 |
| Fax: |