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1174285613
KITI JACKSON
COLUMBIA, MD
NPI
1174285613
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MD LGP11986)
Enumeration Date
2021-10-12
Last Update Date
2021-10-12
Business Address
KITI JACKSON
6440 DOBBIN RD STE D
COLUMBIA, MD 21045-4770
Phone number: 757-593-4272
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Mailing Address
KITI JACKSON
6710 W LAKERIDGE RD
NEW MARKET, MD 21774-6628
Phone number: 757-593-4272
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