Individual
MISS TINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, MAED, L-QMHP A/C
Contact information
Practice address
150 SHELTER COVE WAY, CARROLLTON, VA 23314-4167
(757) 944-4010
Mailing address
150 SHELTER COVE WAY, CARROLLTON, VA 23314-4167
(757) 944-4010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0732006392
VA
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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