Individual
ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W MUHAMMAD ALI BLVD, HUMAN RESOURCES, LOUISVILLE, KY 40202-1423
(502) 589-8600
(502) 589-8771
Mailing address
9702 STONESTREET RD, STE. 110, LOUISVILLE, KY 40272-6808
(502) 589-8600
(502) 589-8771
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
129491
KY
Other
Enumeration date
07/12/2006
Last updated
06/06/2016
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