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1194297036
GIANNA LATRICE JACKSON
WALDORF, MD
NPI
1194297036
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
164X00000X Licensed Vocational Nurse
(Licence: CA 223042)
Enumeration Date
2018-12-17
Last Update Date
2018-12-17
Business Address
Ms. GIANNA LATRICE JACKSON GMFT
2255 CRAIN HWY STE 107
WALDORF, MD 20601-3186
Phone number: 301-292-2778
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Mailing Address
Ms. GIANNA LATRICE JACKSON GMFT
PO BOX 644
TEMPLE HILLS, MD 20757-0644
Phone number: 619-944-9971
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