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Individual

ANGELA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST

Contact information

Practice address
10533 HIGHWAY 67, FREDERICKTOWN, MO 63645-7014
(314) 325-6748
Mailing address
10533 HIGHWAY 67, FREDERICKTOWN, MO 63645-7014
(314) 325-6748

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
MO

Other

Enumeration date
04/28/2022
Last updated
04/28/2022
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