Individual
MR. EDWARD JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1868 NIAGARA FALLS BLVD STE 103, TONAWANDA, NY 14150-6494
(716) 201-0522
Mailing address
1868 NIAGARA FALLS BLVD STE 103, TONAWANDA, NY 14150-6494
(716) 201-0522
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001679
NY
Other
Enumeration date
10/20/2020
Last updated
09/11/2023
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