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Individual

DR. LORI BETH JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
7149 BLACKSHEEP RUN, BLANCHFIELD ARMY COMMUNITY HOSPITAL, FORT CAMPBELL, KY 42223
(270) 798-1698
Mailing address
7149 BLACKSHEEP RUN, FORT CAMPBELL, KY 42223
(270) 798-1698

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1696
AL
103TC0700X
Clinical Psychologist
Primary
1696
AL

Other

Enumeration date
09/19/2011
Last updated
05/09/2025
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