Individual
SARAH JANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD, SUITE D3, AUSTIN, TX 78759-8661
(512) 289-5486
(512) 342-0421
Mailing address
4131 SPICEWOOD SPRINGS RD, SUITE D3, AUSTIN, TX 78759-8661
(512) 289-5486
(512) 342-0421
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25807
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073JB
BLUE CROSS BLUE SHIELD
TX
05
—
0401218-06
—
TX
Enumeration date
06/14/2006
Last updated
07/08/2007
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