Organization
PETER C. JACKSON, PSYD CONSULTING, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER JACKSON (PRESIDENT)
(608) 318-3050
Entity
Organization
Contact information
Practice address
700 RAY O VAC DR, SUITE 220, MADISON, WI 53711-2479
(608) 276-9191
(608) 276-9144
Mailing address
700 RAYOVAC DRIVE SUITE 220, MADISON, WI 53711-2476
(608) 276-9191
(608) 276-9144
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
180557
WI
Other
Enumeration date
04/08/2016
Last updated
08/03/2016
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