Moss Alan Jackson is a Clinical in Ardmore, Pennsylvania. Moss Alan Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Moss Alan Jackson is 1083811012. The last update date is 2007-07-08.
Moss Alan Jackson's current location address is 125 Coulter Ave, Ardmore, Pennsylvania. You can contact this provider via phone number 6106424873 and fax number 6106424886. The mailing address for Moss Alan Jackson is 125 Coulter Ave, Ardmore, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Moss Alan Jackson |
|---|---|
| Address | 125 Coulter Ave, Ardmore, Pennsylvania |
| Phone Number | 6106424873 |
| Fax Number | 6106424886 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1083811012 |
|---|---|
| Provider Enumeration Date | 2007-07-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 125 Coulter Ave |
|---|---|
| City | Ardmore |
| State | Pennsylvania (PA) |
| Post Code | 19003 |
| Phone Number | 6106424873 |
| Fax Number | 6106424886 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PS362 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code assigned to Moss Alan Jackson by the Centers for Medicare & Medicaid Services?
The Moss Alan Jackson has been issued the NPI (National Provider Identifier) 1083811012, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Moss Alan Jackson?
The Moss Alan Jackson is situated at 125 Coulter Ave, in the city of Ardmore, state of PA, with the zip code 19003.
What is Moss Alan Jackson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Moss Alan Jackson is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1083811012 to Moss Alan Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1083811012 to Moss Alan Jackson on 2007-07-02.
When was the Moss Alan Jackson's information last updated?
The Moss Alan Jackson's information was last updated on 2007-07-08.
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