Robert Leon Jackson, PH.D.
NPI #1104032952 in Springfield, Illinois
Provider Information
- NPI Number
- 1104032952
- Entity Type
- Individual
- Name
- Robert Leon Jackson, PH.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Credential
- PH.D.
- Enumeration Date
- May 15, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1201 S VETERANS PKWY
- Address 2
- SUITE B
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62704-6321
- Phone
- (217) 793-2770
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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