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1417281064
SHANNON JACKSON
MANCHESTER, CT
NPI
1417281064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CT 00297)
Enumeration Date
2009-09-30
Last Update Date
2009-09-30
Business Address
Dr. SHANNON JACKSON Psy.D.
150 NORTH MAIN ST ECHN HEALTH SERVICES
MANCHESTER, CT 06040-4188
Phone number: 860-647-6832
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Mailing Address
Dr. SHANNON JACKSON Psy.D.
150 NORTH MAIN STREET ECHN ADULT AMBULATORY SERVICES
MANCHESTER, CT 06040-4188
Phone number: 860-647-6832
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