TYLA JACKSON

Case Manager/Care Coordinator

Active Individual
NPI: 1215420435

Practice Address

70 WOOD ST APT 22
Pawtucket, RI 02860

Phone: (161) 751-6777

Specialties

Specialty Code Primary License
Behavior Technician 106S00000X No -
Case Manager/Care Coordinator 171M00000X Yes -

Frequently Asked Questions

NPI 1215420435 is the National Provider Identifier for TYLA JACKSON, a Case Manager/Care Coordinator provider located in Pawtucket, RI. This NPI was enumerated on June 12, 2018.
TYLA JACKSON practices at 70 WOOD ST APT 22, Pawtucket, RI 02860.

Quick Facts

NPI
1215420435
Type
Individual
Enumerated
Jun 12, 2018
Last Updated
Dec 11, 2020

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