Individual
DONNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 KATHERINE LEE BATES RD # 21, FALMOUTH, MA 02540-2845
(774) 454-3290
Mailing address
155 KATHERINE LEE BATES RD # 21, FALMOUTH, MA 02540-2845
(774) 454-3290
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8102
MA
Other
Enumeration date
02/08/2014
Last updated
02/08/2014
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