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Individual

DR. CHARLES HENRY TALBERT JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LGPC

Contact information

Practice address
11140 ROCKVILLE PIKE STE 602, ROCKVILLE, MD 20852-3184
(301) 591-6830
Mailing address
1461 LEEGATE RD NW, WASHINGTON, DC 20012-1211
(301) 775-7374

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP11776
MD

Other

Enumeration date
03/14/2023
Last updated
06/25/2024
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