Individual
MICHELE ELOISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RESIDENT IN COUNSELI
Contact information
Practice address
123 YEARDLEY DR, NEWPORT NEWS, VA 23601-3233
(757) 281-9098
Mailing address
123 YEARDLEY DR, NEWPORT NEWS, VA 23601-3233
(757) 281-9098
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0704013824
VA
Other
Enumeration date
07/24/2021
Last updated
07/24/2021
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