Individual
REBECCA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
428 E 25TH ST, BALTIMORE, MD 21218-5304
(410) 617-0142
Mailing address
310 TECUMSEH WAY, HAVRE DE GRACE, MD 21078-2870
(443) 752-3119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LG14687
MD
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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