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Individual

DR. TALIA AMO JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD, LP

Contact information

Practice address
2600 WAYZATA BLVD N, MPLS, MN 55405-2123
(612) 444-1745
Mailing address
2600 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2123
(612) 444-1745
(612) 484-4557

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4738
MN
103TC0700X
Clinical Psychologist
LP4738
MN

Other

Enumeration date
10/17/2006
Last updated
02/12/2026
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