Individual
MATTHEW JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
1112 18TH ST # 860051, PLANO, TX 75074-5904
(972) 265-9302
Mailing address
1112 18TH ST # 860051, PLANO, TX 75074-5904
(972) 265-9302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
39612
TX
Other
Enumeration date
09/27/2024
Last updated
05/07/2025
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