Individual
ROBERT DAVID JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018990
MI
Other
Enumeration date
08/01/2020
Last updated
01/03/2025
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