Organization
CHRISTY S. JACKSON, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTY S JACKSON PH.D. (OWNER)
(860) 266-6467
Entity
Organization
Contact information
Practice address
352 MAIN ST, DURHAM, CT 06422-1645
(860) 266-6467
Mailing address
502 CYPRESS RD, NEWINGTON, CT 06111-5618
(860) 301-0053
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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