Individual
DR. JUDITH TEMPLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
125 COULTER AVE, FLOOR 2, ARDMORE, PA 19003-2410
(610) 642-4873
(610) 642-4886
Mailing address
125 COULTER AVE, FLOOR 2, ARDMORE, PA 19003-2410
(610) 642-4873
(610) 642-4886
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
PS007219L
PA
Other
Enumeration date
04/22/2007
Last updated
07/08/2007
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