Individual
DR. LISA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
990 ROUTE 146, CLIFTON PARK, NY 12065-3617
(518) 581-9525
Mailing address
990 ROUTE 146, CLIFTON PARK, NY 12065-3617
(518) 265-5264
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
016988
NY
103TB0200X
Cognitive & Behavioral Psychologist
Primary
016988
NY
Other
Enumeration date
03/20/2007
Last updated
01/07/2014
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