Individual
DR. LISA MARIE JACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
514 W PALMETTO ST, FLORENCE, SC 29501-4428
(843) 319-2310
(855) 328-1383
Mailing address
514 W PALMETTO ST, FLORENCE, SC 29501-4428
(843) 319-2310
(855) 328-1383
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
615
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSO211
—
SC
Enumeration date
01/10/2007
Last updated
05/23/2016
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