Individual
MISS CELITTA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1620 ELTON RD, SUITE 206, SILVER SPRING, MD 20903-1740
(301) 439-7191
(301) 439-1169
Mailing address
26 ARK RD, LOTHIAN, MD 20711-2901
(410) 980-2745
(301) 439-1169
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC5556
MD
Other
Enumeration date
05/30/2015
Last updated
05/30/2015
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