Individual
DR. CELESTIAL WILLS-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
Mailing address
357 ROOSEVELT AVE, FREEPORT, NY 11520-6126
(516) 377-1806
(516) 377-1806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
02/18/2020
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