NPI 1063096147
Antwain Jackson
Practice location
- Address
- 1711 10th Ave SE, Decatur, AL 35601-4915
- Phone
- (256) 226-0150
Registered specialties (2)
Day Training/Habilitation Specialist
Primary
Adult Companion
Registry record
- NPI
- 1063096147
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 5 May 2021
- Record last updated
- 5 May 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.