Theodora Jackson

NPI 1275960189 - Psychologist - 103TS0200X

NPI Details
NPI 1275960189
Gender Female
Enumeration Date 10/09/2013
Last Updated 10/09/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
540 55TH STREET, N.E.
WASHINGTON DC, 20019, US
Phone (202) 939-2030
Fax (202) 388-3849
Business Location
540 55TH STREET, N.E.
WASHINGTON DC, 20019, US
Phone (202) 939-2030
Fax (202) 388-3849
Toxanomy
Taxonomy Code 103TS0200X
License State DO Columbia
License Number CERTIFIED
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According to our database, Ms. Theodora Jackson NPI is 1275960189, taxonomy code is 103TS0200X and license number is CERTIFIED, license state is located at DO Columbia. Theodora Jackson physically located at 540 55th Street, N.e., Washington DC, 20019. NPI Number Theodora Jackson has the Individual type.

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1275960189 NPI number is provided on an as is basis without warranty of any kind. 1275960189 is maintained by the National Plan & Provider Enumeration System. The contents of Theodora Jackson are for informational purposes only.