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1104198522
ILANA JACKSON
BALTIMORE, MD
NPI
1104198522
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MD 05059)
Enumeration Date
2012-01-31
Last Update Date
2016-10-10
Business Address
-- ILANA JACKSON PsyD
1 SUNNY MEADOW CT APT 102
BALTIMORE, MD 21209-1255
Phone number: 908-839-7117
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Mailing Address
-- ILANA JACKSON PsyD
405 ALLEGHENY AVE
TOWSON, MD 21204-4256
Phone number: 908-839-7117
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