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

Theldrina Latina Jackson

Individual provider Behavior Technician · NPI 1104514603

Theldrina Latina Jackson is a Behavior Technician in Watkinsville, Georgia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1360 Caduceus Way Ste 101
Watkinsville, GA 30677-7300
Phone: (762) 499-3476
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1104514603
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 24, 2023
Last updated in NPPESApril 24, 2023
Certification dateApril 24, 2023

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