Organization
SPRINGFIELD CTR PSYCHOLOGICAL SVS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LEON JACKSON PHD (PSYCHOLOGIST PRESIDENT)
(217) 793-2770
Entity
Organization
Contact information
Practice address
1201 S VETERANS PKWY, SUITE B, SPRINGFIELD, IL 62704-6321
(217) 793-2770
(217) 793-2887
Mailing address
1201 S VETERANS PKWY, SUITE B, SPRINGFIELD, IL 62704-6321
(217) 793-2770
(217) 793-2887
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
01/17/2007
Last updated
08/22/2020
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