Individual
MRS. TAKIYA NACHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
2700 S LANG ST, ARLINGTON, VA 22206-3106
(703) 228-6943
Mailing address
2100 WASHINGTON BLVD, ARLINGTON, VA 22204-5703
(703) 228-6061
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0606160
VA
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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