LAVILA D JACKSON

COLUMBIA, MD
NPI1639855836
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X 
Additional Taxonomies101Y00000X Counselor
171M00000X Case Manager/Care Coordinator
Enumeration Date2023-06-23
Last Update Date2024-10-15
Business Address
LAVILA D JACKSON
7090 SAMUEL MORSE DR STE 100
COLUMBIA, MD 21046-3444
Phone number: 443-852-7036
Mailing Address
LAVILA D JACKSON
6246 HEATHER GLEN WAY
CLARKSVILLE, MD 21029-1175
Phone number: 443-852-7036
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