Tanisha Jackson's National Provider Identifier (NPI) Details
Tanisha Jackson,
NPI: 1700395571
Enumeration Date: 2017-09-25
Last updated: 2017-09-25
Sole Proprietor: YES
Status: active
Postal Address: 9500 ANNAPOLIS RD, LANHAM, MD
Phone:
Primary Practice Address: 9500 ANNAPOLIS RD, A8, LANHAM, MD
Practice's phone: 301-710-9400