Individual
VALERIE JACKSON JACKSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4410 FOOTE ST NE, WASHINGTON, DC 20019-4727
(202) 399-1057
Mailing address
4410 FOOTE ST NE, WASHINGTON, DC 20019-4727
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70032809
—
DC
Enumeration date
11/26/2018
Last updated
11/26/2018
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