| Jackson Clinic Llc | |
|
33 Bedford St Ste 11 Lexington MA 02420-4403 | |
| (781) 825-5390 | |
| Not Available |
| Full Name | Jackson Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 33 Bedford St Ste 11, Lexington, Massachusetts |
| Authorized Official Name and Position | Annise Jackson (CEO) |
| Authorized Official Contact | 7818255390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Clinic Llc 20 2nd Ave Apt 512 Burlington MA 01803-4463 Ph: (228) 712-0012 | Jackson Clinic Llc 33 Bedford St Ste 11 Lexington MA 02420-4403 Ph: (781) 825-5390 |
| NPI Number | 1235873811 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 04/21/2022 |
| Certification Date | 04/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235873811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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