Individual
MIRAYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
7205 RUTHERFORD RD, BALTIMORE, MD 21244-2711
(443) 780-1403
Mailing address
7205 RUTHERFORD RD, BALTIMORE, MD 21244-2711
(443) 780-1403
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
27195
MD
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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