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Individual

OMEAKA JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
204 CEDAR ST, STE 102, CAMBRIDGE, MD 21613-2395
(301) 728-3857
Mailing address
204 CEDAR ST, STE 102, CAMBRIDGE, MD 21613-2395
(301) 728-3857

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC5086
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0723835
MD
Enumeration date
05/31/2012
Last updated
05/24/2016
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