Jackson, Brian Frederick
Jackson, Brian Frederick is an sole proprietor health care provider with primary practice located at 4 Back River Rd , Dover NH 03820-4404. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Jackson, Brian Frederick can be contacted via phone (603) 742-1373.Contact Information
Primary practice address
4 Back River Rd
Dover NH 03820-4404
Phone: (603) 742-1373
Fax: (603) 742-1373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 778 | New Hampshire |
Profile Details
| NPI number | 1891887758 |
|---|---|
| LBN Legal business name | Jackson, Brian Frederick |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891887758 | NPPES |
| New Hampshire | MEDICAID | 30007230 |
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