DR. Shannon Jackson, PSY.D.
NPI #1417281064 in Manchester, Connecticut
Provider Information
- NPI Number
- 1417281064
- Entity Type
- Individual
- Name
- DR. Shannon Jackson, PSY.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Credential
- PSY.D.
- Enumeration Date
- Sep 30, 2009
- Last Updated
- Sep 30, 2009
Practice Location
- Address
- 150 NORTH MAIN ST
- Address 2
- ECHN HEALTH SERVICES
- City
- Manchester
- State
- Connecticut
- ZIP Code
- 06040-4188
- Phone
- (860) 647-6832
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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