Individual
DAIJA ADEINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-4141
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-4141
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008767
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
04/22/2026
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