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Individual

MR. CHARLES E. JACKSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW-C, LICSW

Contact information

Practice address
10 N. GREENE STREEET, BALTIMORE, MD 21201
(410) 605-7279
Mailing address
10 N. GREENE STREEET, BALTIMORE, MD 21201
(410) 605-7279

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
G10149
MD

Other

Enumeration date
09/20/2006
Last updated
01/09/2008
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