Jackson, Sandra Lydia
Jackson, Sandra Lydia is an sole proprietor health care provider with primary practice located at 3102 Floral Park Rd , Clinton MD 20735-9665. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Sandra Lydia can be contacted via phone (301) 292-2778.Contact Information
Primary practice address
3102 Floral Park Rd
Clinton MD 20735-9665
Phone: (301) 292-2778
Fax: (301) 292-0275
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 09990 | Maryland |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC302754 | District of Columbia |
Profile Details
| NPI number | 1467767319 |
|---|---|
| LBN Legal business name | Jackson, Sandra Lydia |
| Credentials | LICSW, LCSW-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2010 |
| Last updated | Aug 16th, 2010 - about 16 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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