Individual
DR. WILLIAM SPENCER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
880 W 12TH ST, RENO, NV 89503-2601
(775) 982-5318
Mailing address
880 W 12TH ST, RENO, NV 89503-2601
(775) 746-1869
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC 00248-L
NV
103TC0700X
Clinical Psychologist
13587
CA
103TC0700X
Clinical Psychologist
Primary
PY0264
NV
Other
Enumeration date
02/14/2007
Last updated
11/10/2010
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