Individual
MISS JACKIE RENEA BYERS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC
Contact information
Practice address
1900 MASSACHUSETTS AVE SE BLDG 13, WASHINGTON, DC 20003-2542
(202) 682-6599
Mailing address
4418 3RD ST SE APT C, WASHINGTON, DC 20032-3233
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CACI1018
DC
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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