Organization
ANGELIQUE JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE JACKSON (THERAPIST)
(484) 891-0906
Entity
Organization
Contact information
Practice address
539 LEHIGH ST, CATASAUQUA, PA 18032-2017
(484) 891-0906
Mailing address
539 LEHIGH ST, CATASAUQUA, PA 18032-2017
(484) 891-0906
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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