Individual
WANDA ELIZABETH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2018 ROCK SPRING RD, A6, FOREST HILL, MD 21050-2631
(410) 838-2493
(410) 838-2547
Mailing address
4006 JEFFERY CT, ABINGDON, MD 21009-3073
(410) 515-0443
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP3349
MD
101YP2500X
Professional Counselor
—
MD
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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