Individual
MS. DORYE EMORY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
50 WASHINGTON STREET, SUITE 750, NORWALK, CT 06854
(203) 979-3503
Mailing address
458 WIRE MILL ROAD, STAMFORD, CT 06903
(203) 979-3503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
008194
CT
103TC1900X
Counseling Psychologist
008194
CT
106H00000X
Marriage & Family Therapist
008194
CT
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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