Individual
LISA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20111 HORACE HARDING EXPY, OAKLAND GARDENS, NY 11364-1639
(347) 624-9688
Mailing address
20111 HORACE HARDING EXPY, OAKLAND GARDENS, NY 11364-1639
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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