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NPI Profile for JENNIFER M JACKSON ALLEN in STOCKBRIDGE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
School |
103TS0200X | 62 | Psychologist, Clinical |
| NPI # | 1043705262 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/29/2018 | |
| Last updated | 06/16/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JENNIFER M JACKSON ALLEN