Jackson, Keira Michelle

Jackson, Keira Michelle is an sole proprietor health care provider with primary practice located at 8601 Rose Mallow Dr Apt 415 , Manassas VA 20109-4025. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Keira Michelle can be contacted via phone (757) 232-9100.

Contact Information

Primary practice address
8601 Rose Mallow Dr Apt 415 Manassas VA 20109-4025
Phone: (757) 232-9100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0710103585 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0704014248 Virginia

Profile Details

NPI number 1699249839
LBN Legal business name Jackson, Keira Michelle
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 21st, 2019
Last updated Oct 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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