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

Latasha Monique Jackson

Individual provider Behavior Technician · NPI 1639938640

Latasha Monique Jackson is a Behavior Technician in Hephzibah, Georgia. Licensed in Georgia. Registered with an NPI since 2024.

Licensed in
GA
In the registry since
2024

Practice location Address checks out

3912 Lakeside Pass
Hephzibah, GA 30815-4728
Phone: (706) 804-1499
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (GA)

Record details

NPI number1639938640
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 13, 2024
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024
Mailing address3912 Lakeside Pass, Hephzibah, GA 30815-4728

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