ROBERT LEON JACKSON

SPRINGFIELD, IL
NPI1104032952
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: IL  IL071-001761)
Enumeration Date2007-05-15
Last Update Date2007-07-08
Business Address
-- ROBERT LEON JACKSON Ph.D.
1201 S VETERANS PKWY SUITE B
SPRINGFIELD, IL 62704-6321
Phone number: 217-793-2770
Mailing Address
-- ROBERT LEON JACKSON Ph.D.
16 LONGBOW LN
SPRINGFIELD, IL 62704-5324
Phone number: 217-787-3143
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