Individual
SHERYL R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1215 HALL-JOHNSON RD, STE 100, COLLEYVILLE, TX 76034
(817) 909-7995
(817) 428-9885
Mailing address
2765 MESQUITE LN, GRAPEVINE, TX 76051-7166
(682) 223-1026
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1447
AL
103TC0700X
Clinical Psychologist
Primary
33305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R99502
VIVA
AL
Enumeration date
07/03/2006
Last updated
07/08/2007
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