Individual
STEPHANIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACI
Contact information
Practice address
508 KENNEDY ST NW, WASHINGTON, DC 20011-3137
(202) 223-9630
Mailing address
508 KENNEDY ST NW, WASHINGTON, DC 20011-3137
(202) 223-9630
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CACI1124
DC
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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