Individual
JENNIFER J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
364 E. MAIN STREET, NEWARK, DE 19711
(302) 319-0518
(484) 667-8047
Mailing address
303 JOHN HANCOCK BLVD, LINCOLN UNIVERSITY, PA 19352-9311
(302) 319-0518
(484) 667-8047
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029057320001
—
PA
05
—
200188406
—
DE
Enumeration date
02/27/2010
Last updated
02/21/2017
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