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Individual

DR. REBEKAH JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
446A BLAKE ST, SUITE 200, NEW HAVEN, CT 06515-1286
(203) 387-9400
(888) 772-2160
Mailing address
446A BLAKE ST, SUITE 200, NEW HAVEN, CT 06515-1286
(203) 387-9400
(888) 772-2160

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003182
CT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/20/2011
Last updated
07/02/2012
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