Most Relevant Information
Provider Data
| NPI Number: | 1003328378 |
| Provider Name: | JACKSON L STEWART PSYCHOLOGIST |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | PS004481L |
Most Important Dates
| Enumeration Date: | 10/26/2017 |
| Last Updated: | 10/26/2017 |
Provider Practice Location
110 CAMPUS DR
BRADFORD
PA
167011982
Practice Location Phone/Fax
| Phone: | 8143626535 |
| Fax: |
Provider Mailing Location
110 CAMPUS DR
BRADFORD
PA
167011982
Provider Mailing Phone/Fax
| Phone: | 8143626535 |
| Fax: |