Individual provider · Type 1 NPI

Ladonya Jackson, PhD

Student in an Organized Health Care Education/Training Program · Boston, MA

NPI number 1194474049 Active

Practice location

55 Fruit St
Boston, MA 02114-2621

Call (617) 726-2000 Map

Mailing address

1120 15th St
Augusta, GA 30912-0004

Other practice locations

  • 1120 15th St, Augusta, GA 30912-0004 · (408) 300-4456

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1194474049

Ladonya Jackson, PhD's National Provider Identifier is 1194474049, issued on Mar 19, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Boston, MA. The record was last updated on Mar 18, 2023.