Individual
DR. MONICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5064
OH
Other
Enumeration date
03/12/2009
Last updated
03/12/2009
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