Individual
MR. DONALD WAYNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3434 MOUNT BURNSIDE WAY, WOODBRIDGE, VA 22192-1013
(703) 490-8250
(703) 490-8282
Mailing address
3434 MOUNT BURNSIDE WAY, WOODBRIDGE, VA 22192-1013
(703) 490-8250
(703) 490-8282
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
NC
Other
Enumeration date
03/30/2009
Last updated
03/30/2009
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