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1184047698
ERIC D JACKSON
ORANGE, CT
NPI
1184047698
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CT 003329)
Enumeration Date
2014-02-04
Last Update Date
2014-02-04
Business Address
-- ERIC D JACKSON PhD
35 OLD TAVERN RD SUITE 103
ORANGE, CT 06477-3450
Phone number: 203-701-9666
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Mailing Address
-- ERIC D JACKSON PhD
88 E BROADWAY APT B
MILFORD, CT 06460-6128
Phone number: 203-701-9666
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