ELAINE JACKSON

PHILADELPHIA, PA
NPI1700338142
Former NameELAINE SMITH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: MD  LC9062)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: DC  LGPC00898)
101YM0800X Counselor, Mental Health
(Licence: VA  0701010327)
101YM0800X Counselor, Mental Health
(Licence: MD  LGP7431)
Enumeration Date2016-11-02
Last Update Date2023-04-10
Business Address
ELAINE JACKSON LCPC
325 CHERRY ST
PHILADELPHIA, PA 19106-2061
Phone number: 202-780-5333
Mailing Address
ELAINE JACKSON LCPC
325 CHERRY ST
PHILADELPHIA, PA 19106-2061
Phone number: 202-780-5333