Carol A Jackson
NPI #1376826693 in Taos, New Mexico
Provider Information
- NPI Number
- 1376826693
- Entity Type
- Individual
- Name
- Carol A Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - School
- Enumeration Date
- Sep 22, 2011
- Last Updated
- Sep 22, 2011
Practice Location
- Address
- 110 PASEO DEL CANON W
- City
- Taos
- State
- New Mexico
- ZIP Code
- 87571-6743
- Phone
- (575) 779-6138
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - School — School |
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