Individual
DR. JOHN LAWRENCE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3056 S 700 E APT C, SALT LAKE CITY, UT 84106-1682
(706) 936-6422
Mailing address
3056 S 700 E APT C, SALT LAKE CITY, UT 84106-1682
(706) 936-6422
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
12900024-2501
UT
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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