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1033865639
NICOLE JACKSON
ELLICOTT CITY, MD
NPI
1033865639
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MD LGP12368)
Enumeration Date
2022-02-23
Last Update Date
2022-02-23
Business Address
NICOLE JACKSON LGPC
787 OELLA AVE
ELLICOTT CITY, MD 21043-4727
Phone number: 443-720-0090
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Mailing Address
NICOLE JACKSON LGPC
2213 ROGENE DR APT 101
BALTIMORE, MD 21209-5730
Phone number: 240-304-6414
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