Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
184 LIBERTY ST, NEW HAVEN, CT 06519-1625
(203) 688-9944
Mailing address
200 BLOOMFIELD AVE, WEST HARTFORD, CT 06117-1545
(860) 263-9686
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/18/2023
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