Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cordetta Lashawn Jackson

Individual provider Behavior Technician · NPI 1699418582

Cordetta Lashawn Jackson is a Behavior Technician in Southlake, Texas. Licensed in Texas. Registered with an NPI since 2022.

Licensed in
TX
In the registry since
2022

Practice location Address checks out

2104 Greenbriar Dr
Southlake, TX 76092-8355
Phone: (817) 442-9022
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence RBT-18-16039 (TX)

Record details

NPI number1699418582
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 18, 2022
Last updated in NPPESApril 18, 2022
Certification dateApril 18, 2022
Mailing address2104 Greenbriar Dr, Southlake, TX 76092-8355

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