Individual
KRISTIN MARY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
410 N PRINCE ST, LANCASTER, PA 17603-3010
(717) 560-7917
Mailing address
410 N PRINCE ST, LANCASTER, PA 17603-3010
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
BH002643
PA
103T00000X
Psychologist
Primary
PS018008
PA
Other
Enumeration date
11/11/2013
Last updated
02/09/2016
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