Individual
MS. BETTINA MONET JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
10312 GRANDHAVEN AVE, UPPER MARLBORO, MD 20772-6602
(202) 352-5699
Mailing address
10312 GRANDHAVEN AVE, UPPER MARLBORO, MD 20772-6602
(202) 352-5699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
03049
MD
Other
Enumeration date
12/04/2005
Last updated
08/06/2013
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