Individual
GABRIELLE JACKSON
Active
Individual
GABRIELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, LCSW, LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904009476
VA
1041C0700X
Clinical Social Worker
Primary
17526
MD
1041C0700X
Clinical Social Worker
LC50080738
DC
Other
Enumeration date
02/19/2019
Last updated
05/20/2024
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