Individual
LAURA JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 MAPLE RD, JOLIET, IL 60432-1442
(815) 735-0732
Mailing address
604 LAMBETH LN, NEW LENOX, IL 60451-9638
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
180.003361
IL
Other
Enumeration date
10/05/2008
Last updated
10/05/2008
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