Individual
HOPE LACHIEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14121 PARKE LONG COURT, SUITE 201, CHANTILLY, VA 20151
(757) 323-4471
Mailing address
14121 PARKE LONG CT STE 201, CHANTILLY, VA 20151-1647
(757) 323-4471
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002064783
VA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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