Individual
MRS. NASHOTA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, NCC
Contact information
Practice address
611 RIDGELY AVE, ANNAPOLIS, MD 21401-1069
(410) 803-3318
Mailing address
1121 CRESTVIEW DR, ANNAPOLIS, MD 21409-4803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LC10411
MD
Other
Enumeration date
07/25/2018
Last updated
05/14/2020
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