Individual
ASIA K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
9649 BELAIR RD STE 104, NOTTINGHAM, MD 21236-1117
(410) 529-1309
Mailing address
3 DUNHAVEN PL APT 1C, NOTTINGHAM, MD 21236-7552
(443) 619-8186
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP11866
MD
Other
Enumeration date
10/12/2021
Last updated
01/03/2025
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