Individual
EBONY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 NEW YORK AVE NE, WASHINGTON, DC 20002-1848
(202) 269-2401
Mailing address
1818 NEW YORK AVE NE STE 115, WASHINGTON, DC 20002-1851
(202) 269-2401
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
07/11/2023
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