National Provider Identifier
Lisa Ann Jackson, PHD
Lisa Ann Jackson, PHD is listed in the NPPES registry with a primary specialty of Clinical Neuropsychologist in Amherst, NY and a listed phone number of (716) 833-0292.
Profile Overview
- NPI
- 1316071749
- Provider Type
- Individual
- Primary Specialty
- Clinical Neuropsychologist
- Enumeration Date
- March 15, 2007
- Last Updated
- July 08, 2007
Practice Location
- 4955 N Bailey Ave
- Amherst, NY 14226-1206
Phone: (716) 833-0292
Mailing Address
- 332 Dan Troy Dr
- Williamsville, NY 14221-3514
Specialties
- Clinical Neuropsychologist (103G00000X)
Full Record
- NPI
- 1316071749
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Lisa
- Middle Name
- Ann
- Name Prefix
- Dr.
- Credential
- PHD
- Mailing Street Address
- 332 Dan Troy Dr
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-3514
- Mailing Country
- US
- Mailing Phone
- (716) 839-4658
- Practice Street Address
- 4955 N Bailey Ave
- Practice City
- Amherst
- Practice State
- NY
- Practice ZIP Code
- 14226-1206
- Practice Country
- US
- Practice Phone
- (716) 833-0292
- Practice Fax
- (716) 833-0215
- Enumeration Date
- March 15, 2007
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Neuropsychologist (103G00000X)
- Other Identifiers
- 01474937 (NY)