Individual
JOHN L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
PO BOX 1718, MARYLAND HEIGHTS, MO 63043-0718
(224) 935-9807
(888) 656-4903
Mailing address
PO BOX 1718, MARYLAND HEIGHTS, MO 63043-0718
(224) 935-9807
(888) 656-4903
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003528
IL
Other
Enumeration date
05/02/2007
Last updated
01/28/2025
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