Individual
JACKSON TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 E 102ND ST, SUITE 215, NEW YORK, NY 10029-5611
(212) 241-8462
Mailing address
85 CROOKE AVE APT 9, BROOKLYN, NY 11226-1681
(845) 568-7234
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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