Individual
JOELISA W JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5118 JUST ST NE, WASHINGTON, DC 20019-5560
(202) 802-1644
Mailing address
5118 JUST ST NE, WASHINGTON, DC 20019-5560
(202) 802-1644
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
1256-0428-1822
DC
3747P1801X
Personal Care Attendant
Primary
—
DC
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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