Individual
SHELBY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13400 EDGEMEADE RD, UPPER MARLBORO, MD 20772-8088
(240) 681-6000
Mailing address
13400 EDGEMEADE RD, UPPER MARLBORO, MD 20772-8088
(240) 681-6000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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