| Doctor Name: | ROBIN EDMUND JACKSON |
| NPI Number: | 1154308831 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | LSW-1048 |
| Business Practice Address: | 300 Tuskegee Blvd Dover Afb, DE - 199025300 |
| Business Phone Number: | 3026773911 |
| Business Fax Number: | |
| Mailing Address: | 339 Hiawatha Ln, DOVER |
| State: | DE |
| Postal Code: | 199042471 |
| Phone Number: | 3026782196 |
| Fax Number: | |
| NPI Enumeration Date: | 12/23/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LSW-1048 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |