Individual
MS. STEFANI MICHON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
880 SUNNY LAKE DR, LAWRENCEVILLE, GA 30043-4562
(301) 284-8176
Mailing address
1531 ROCKVILLE PIKE STE 1043, ROCKVILLE, MD 20852-1601
(301) 284-8176
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24016
MD
Other
Enumeration date
10/06/2021
Last updated
12/16/2024
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