Individual
NICOLE JACKSON-WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
9515 DEERECO RD STE 306, LUTHERVILLE TIMONIUM, MD 21093-2152
(410) 231-3016
Mailing address
9515 DEERECO RD STE 306, LUTHERVILLE TIMONIUM, MD 21093-2152
(410) 231-3016
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
LC12858
MD
101YP2500X
Professional Counselor
PC012337
PA
Other
Enumeration date
09/25/2018
Last updated
01/17/2023
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