IndividualActive
Ayanna Jackson
NPI 1205515525 · Behavior Technician · Moncks Corner, SC
Provider details
- NPI number
- 1205515525
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
111 Kitfield Rd
Moncks Corner, SC 29461-4210
Phone: (843) 499-0516
Approximate (ZIP-level) locationGet directions
Mailing address
111 Kitfield Rd
Moncks Corner, SC 29461-4210
Registry dates
- Enumerated
- 2023-07-13
- Last updated
- 2023-07-13
- Certified
- 2023-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.