Tara M Jackson
Tara M Jackson is a Developmental Therapist in Auburn, Kentucky. Practices as a sole proprietor. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
104 G Corum LnAuburn, KY 42206-5000
Phone: (270) 847-7004
Fax: (270) 542-2519
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Specialties & licences
| Developmental Therapist (primary) | Taxonomy 222Q00000X |
|---|
Record details
| NPI number | 1578784245 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 1, 2007 |
| Last updated in NPPES | April 29, 2020 |
| Certification date | April 29, 2020 |
| Mailing address | 104 G Corum Ln, Auburn, KY 42206-5000 |
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