Individual
CHANEL R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1471 HOWARD RD SE, WASHINGTON, DC 20020-4493
(202) 607-3628
Mailing address
1471 HOWARD RD SE, WASHINGTON, DC 20020-4493
(202) 607-3628
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/13/2017
Last updated
07/21/2022
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