Janissa D Jackson Phd Pllc in Fayetteville - Clinical Child & Adolescent
Janissa D Jackson Phd Pllc - NPI 1871762476
Janissa D Jackson Phd Pllc is a Clinical Child & Adolescent in Fayetteville, Arkansas. Janissa D Jackson Phd Pllc practices all healthcare services and medical treatments related to Clinical Child & Adolescent. 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 Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 07-01P |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
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 Child & Adolescent, and the corresponding taxonomy classification code for this specialized field is 103Tc2200X.
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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