| NPI | 1649054743 |
|---|---|
| Other Name | LAUREN I JACKSON, PHD, PLLC |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA PIERING Billing Manager 469-236-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-25 |