Individual
CHARMELLE RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 CARPENTER ST SE, WASHINGTON, DC 20020-2340
(202) 891-9450
Mailing address
3712 CARPENTER ST SE, WASHINGTON, DC 20020-2340
(202) 891-9450
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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