Organization
SHILOH CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAY E JACKSON PSYCHOLOGIST (EXECUTIVE DIRECTOR)
(212) 564-7631
Entity
Organization
Contact information
Practice address
566 7TH AVE FL 4, NEW YORK, NY 10018-1802
(212) 564-7631
(212) 564-7819
Mailing address
566 7TH AVE FL 4, NEW YORK, NY 10018-1802
(212) 564-7631
(212) 564-7819
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
012747-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02966163
—
NY
Enumeration date
07/13/2009
Last updated
08/02/2023
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