Individual
MARVIN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1356 TALBERT CT SE, WASHINGTON, DC 20020-5205
(202) 809-1915
Mailing address
1356 TALBERT CT SE, WASHINGTON, DC 20020-5205
(202) 809-1915
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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