NPI | 1073124772 |
---|---|
Doing Business As | CRYSTAL A. JACKSON, PH.D. , LLP, LLC |
Entity Type | Organization |
Authorized Contact | CRYSTAL A JACKSON Owner/Psychologist 586-943-0563 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Enumeration Date | 2020-08-14 |
Last Update Date | 2020-10-19 |