Individual
INDIA BEATRICE SOJOURNER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
312 MARTIN LUTHER KING JR BLVD STE 300, BALTIMORE, MD 21201-1221
(443) 759-9592
Mailing address
4307 SPRING FOAL CT, UPPER MARLBORO, MD 20772-8326
(202) 212-9204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LGP13552
MD
101YP2500X
Professional Counselor
Primary
LGP13552
MD
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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