Individual provider · Type 1 NPI
Shantell Jackson
Intellectual & Developmental Disabilities Psychologist · Wickliffe, OH
NPI number
1992307870
Active
Practice location
1834 Robindale St
Wickliffe, OH 44092-1843
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual & Developmental Disabilities Psychologist Primary | 103TM1800X | 4303862 (OH) |
Intellectual & Developmental Disabilities Psychologist: Definition to come...
About NPI 1992307870
Shantell Jackson's National Provider Identifier is 1992307870, issued on Nov 15, 2020. The primary taxonomy on file is Intellectual & Developmental Disabilities Psychologist (103TM1800X), and the practice location is in Wickliffe, OH. The record was last updated on Nov 15, 2020.