Most Relevant Information
Provider Data
| NPI Number: | 1003677006 |
| Provider Name: | ROBERT JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/17/2024 |
| Last Updated: | 01/17/2024 |
Provider Practice Location
600 WAYNE AVE
DAYTON
OH
454101122
Practice Location Phone/Fax
| Phone: | 9374962000 |
| Fax: |
Provider Mailing Location
600 WAYNE AVE
DAYTON
OH
454101122
Provider Mailing Phone/Fax
| Phone: | 9374962000 |
| Fax: |