Jackson, Ronell

Jackson, Ronell is an sole proprietor health care provider with primary practice located at 6806 Central Ave Apt 404 , Capitol Heights MD 20743-2781. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Jackson, Ronell can be contacted via phone (240) 437-9516.

Contact Information

Primary practice address
6806 Central Ave Apt 404 Capitol Heights MD 20743-2781
Fax:
Website:

Health care specialties

Profile Details

NPI number 1356827307
LBN Legal business name Jackson, Ronell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2018
Last updated Jul 12th, 2018 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1356827307 NPPES
Maryland MEDICAID 16239708900

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