Individual
EMILY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 BUFORD RD STE 110, NORTH CHESTERFIELD, VA 23235-5292
(804) 447-6382
Mailing address
2106 FLOYD AVE, RICHMOND, VA 23220-4532
(540) 797-3675
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701998652
VA
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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