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Individual

LATRICE S JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8009 PARKS LN, WINDSOR MILL, MD 21244-2151
(443) 583-9562
Mailing address
637 WYNDSTAR CIR, WESTMINSTER, MD 21158-4439
(443) 583-9562

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP14668
MD

Other

Enumeration date
08/27/2025
Last updated
08/27/2025
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