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Individual

DR. MELANIE HOPE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LLC

Contact information

Practice address
2864 DAUPHIN ST, SUITE A, MOBILE, AL 36606-2479
(251) 259-8573
(251) 470-7609
Mailing address
2864 DAUPHIN ST, SUITE A, MOBILE, AL 36606-2479
(251) 259-8573
(251) 470-7609

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1369
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H398
GROUP MEDICARE
AL
Enumeration date
12/20/2005
Last updated
01/30/2008
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