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NPI Code Detail

MEDICARE: DR. SUSAN ANN HOOD-JACKSON PHD

MEDICARE: DR. SUSAN ANN HOOD-JACKSON PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPY0329NV

General Provider Information

NPI Number : 1841487386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN ANN HOOD-JACKSON PHD
Provider Business Mailing Address
First Line : 8430 W LAKE MEAD BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-7674
Country : US
Telephone Number : 702-525-9375
Fax Number : 702-776-3833
Provider Business Practice Location Address
First Line : 8430 W LAKE MEAD BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-7674
Country : US
Telephone Number : 702-858-9355
Fax Number : 702-776-3833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2007
Last Update Date : 04/23/2019

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