Individual
DENISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3110 ESTHER PL SE, WASHINGTON, DC 20032-1505
(202) 594-5141
Mailing address
3533 18TH ST SE, WASHINGTON, DC 20020-2211
(202) 760-9373
(202) 563-5703
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2188969
ID
DC
Enumeration date
03/08/2019
Last updated
03/08/2019
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