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Individual

DR. JARED A JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
6102 TENNESSEE AVE, FORT CAMPBELL, KY 42223-5940
(909) 810-7332
Mailing address
BLDG 6102 TENNESSEE, FORT CAMPBELL, KY 42223
(909) 810-7332

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1690
AL

Other

Enumeration date
07/27/2011
Last updated
05/08/2025
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