Organization
JACKSON PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRINA BOTHE JACKSON PSY.D. (CLINICAL PSYCHOLOGIST, OWNER)
(423) 650-1851
Entity
Organization
Contact information
Practice address
97 MAIN ST, LANCASTER, NH 03584-3063
(423) 650-1851
Mailing address
127 ELM ST, LANCASTER, NH 03584-3107
(423) 650-1851
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1268
NH
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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