Individual
DR. TRINA BOTHE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
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
01/02/2013
Last updated
01/02/2013
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