Individual
DERRICK A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 LENFANT SQ SE, WASHINGTON, DC 20020-6724
(202) 269-2401
(202) 269-2402
Mailing address
1301 LENFANT SQ SE, WASHINGTON, DC 20020-6724
(202) 320-2384
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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