Individual
ALLAN JAMES JACKSON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
(718) 954-3800
Mailing address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
(718) 954-3800
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
0
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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