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Dr. Judith Temple Jackson, PSYCHOLOGIST
Prescribing (Medical) Psychologist in Ardmore, Pennsylvania
NPI 1497973911

Judith Temple Jackson is a Prescribing (Medical) Psychologist based in Ardmore, PA and is specialized in Prescribing (Medical). Judith Temple Jackson practices in Ardmore, PA and has the professional credentials of PSYCHOLOGIST. The NPI Number for Judith Temple Jackson is 1497973911 and holds a License No. PS007219L (Pennsylvania).

The current practice location address for Judith Temple Jackson is 125 Coulter Ave, Ardmore, PA and can be reached out via phone at 610-642-4873 and via fax at 610-642-4886.

Location: 125 Coulter Ave, Ardmore, PA, 19003-2410
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497973911
Provider Name
Judith Temple Jackson
Credential
PSYCHOLOGIST
Provider Entity Type
Individual
Gender
Female
Address
125 Coulter Ave, Ardmore, PA, 19003-2410
Phone Number
610-642-4873
Fax Number
610-642-4886
Provider Enumeration Date
04/22/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
125 Coulter Ave
City
Ardmore
State
Pennsylvania
Zip
19003-2410
Phone Number
610-642-4873
Fax Number
610-642-4886
person
Provider Business Mailing Address Details
Address
125 Coulter Ave
City
Ardmore
State
Pennsylvania
Zip
19003-2410
Phone Number
610-642-4873
Fax Number
610-642-4886
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
PS007219L (Pennsylvania)
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
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