Organization
LISA JACKSON, PHD & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JACKSON (LICENSED PSYCHOLOGIST)
(518) 265-5264
Entity
Organization
Contact information
Practice address
1745 ROUTE 9, HALFMOON, NY 12065-2470
(518) 371-2210
Mailing address
1745 ROUTE 9, HALFMOON, NY 12065-2470
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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