Individual
DR. KRISTEN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6862 ELM ST, 205, MC LEAN, VA 22101-3897
(914) 497-8212
Mailing address
6862 ELM ST, 205, MC LEAN, VA 22101-3897
(914) 497-8212
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005603
VA
Other
Enumeration date
06/23/2009
Last updated
01/10/2017
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