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1699408682
SIMAJAH DOMINIQUE JACKSON
FAIRFAX, VA
NPI
1699408682
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904013854)
Enumeration Date
2022-07-06
Last Update Date
2022-07-06
Business Address
Ms. SIMAJAH DOMINIQUE JACKSON LCSW
4410 SHIRLEY GATE RD
FAIRFAX, VA 22030-5518
Phone number: 703-205-9452
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Mailing Address
Ms. SIMAJAH DOMINIQUE JACKSON LCSW
14166 CUDDY LOOP APT 304
WOODBRIDGE, VA 22193-5995
Phone number: 254-423-8065
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