Janissa D Jackson Phd Pllc in Fayetteville - Clinical
Janissa D Jackson Phd Pllc - NPI 1871762476
Janissa D Jackson Phd Pllc is a Clinical in Fayetteville, Arkansas. Janissa D Jackson Phd Pllc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Janissa D Jackson Phd Pllc is 1871762476. The last update date is 2008-02-27.
Janissa D Jackson Phd Pllc's current location address is 1 W Sunbridge Dr, Fayetteville, Arkansas. You can contact this provider via phone number 4794435575 and fax number 4794439554. The mailing address for Janissa D Jackson Phd Pllc is 1 W Sunbridge Dr, Fayetteville, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Janissa D Jackson Phd Pllc |
|---|---|
| Address | 1 W Sunbridge Dr, Fayetteville, Arkansas |
| Phone Number | 4794435575 |
| Fax Number | 4794439554 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BUSINESS M |
|---|---|
| Authorized Official Name | Latta Lavonna |
| Telephone Number | 4794435575 |
NPI Number Detail
| NPI Number | 1871762476 |
|---|---|
| Provider Enumeration Date | 2008-02-27 |
| Last Updated Date | 2008-02-27 |
Provider Mailing Address Detail
| Address | 1 W Sunbridge Dr |
|---|---|
| City | Fayetteville |
| State | Arkansas (AR) |
| Post Code | 727031825 |
| Phone Number | 4794435575 |
| Fax Number | 4794439554 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 07-01P |
|
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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5A252 | AR | BLUECROSS BLUESHIELD |
Post Comment/ Review Below
What is the Janissa D Jackson Phd Pllc's 1871762476?
The Janissa D Jackson Phd Pllc's NPI (National Provider Identifier) Number is 1871762476. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Janissa D Jackson Phd Pllc located?
The Janissa D Jackson Phd Pllc is located at 1 W Sunbridge Dr, Fayetteville, AR 727031825.
What is Janissa D Jackson Phd Pllc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Janissa D Jackson Phd Pllc is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
When did Janissa D Jackson Phd Pllc receive its 1871762476 assignment?
The Janissa D Jackson Phd Pllc was assigned its 1871762476 on 2008-02-27, which is the date when this unique identifier was issued to the organization.
When was the information pertaining to Janissa D Jackson Phd Pllc most recently updated or revised?
The details related to Janissa D Jackson Phd Pllc, including its address, specialty, and other relevant information, were last updated or revised on 2008-02-27.
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