Jennifer L Jackson is a Family in Summit, New Jersey. Jennifer L Jackson practices all healthcare services and medical treatments related to Family. The NPI Number for Jennifer L Jackson is 1336360247. The last update date is 2010-07-15.
Jennifer L Jackson's current location address is 35 Deforest Ave, Summit, New Jersey. You can contact this provider via phone number 9176854207. The mailing address for Jennifer L Jackson is 35 Deforest Ave, Summit, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer L Jackson |
|---|---|
| Address | 35 Deforest Ave, Summit, New Jersey |
| Phone Number | 9176854207 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1336360247 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2010-07-15 |
Provider Mailing Address Detail
| Address | 35 Deforest Ave |
|---|---|
| City | Summit |
| State | New Jersey (NJ) |
| Post Code | 79012155 |
| Phone Number | 9176854207 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 103Tf0000X |
| Licence No | 16536 |
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Definition: A psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, intervention and research. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4661 | NJ | LICENSE |
Post Comment/ Review Below
What is the Jennifer L Jackson's 1336360247?
The Jennifer L Jackson's NPI (National Provider Identifier) Number is 1336360247. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Jennifer L Jackson's facilities are situated?
The facilities of Jennifer L Jackson are physically located at the following address: 35 Deforest Ave, Summit, NJ, 79012155.
What is the Jennifer L Jackson's area of specialization and corresponding taxonomy classification?
The Jennifer L Jackson's specialty field is Family, and it falls under the taxonomy code 103Tf0000X, which categorizes healthcare providers based on their specialties.
On what date was the 1336360247 assigned to Jennifer L Jackson?
The Jennifer L Jackson was issued its 1336360247 on 2007-05-01, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Jennifer L Jackson's information last updated?
The Jennifer L Jackson's information was last updated on 2010-07-15.