Organization
MONTGOMERY BEHAVIORAL HEALTH INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA L. JACKSON PSY.D. (CLINICAL PSYCHOLOGIST)
(214) 356-0335
Entity
Organization
Contact information
Practice address
2506 S LANCASTER RD, DALLAS, TX 75216-2532
(214) 356-0335
Mailing address
4447 N CENTRAL EXPY, SUITE 110 PMB 231, DALLAS, TX 75205-4245
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34857
TX
Other
Enumeration date
04/27/2011
Last updated
03/23/2012
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