Individual
MELODY V JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
35 K ST NE, WASHINGTON, DC 20002-4216
(202) 442-4108
(202) 371-1657
Mailing address
15101 INTERLACHEN DR, SILVER SPRING, MD 20906-5601
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
M617-2006
DC
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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