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Individual
DR. TONJANIKA JACKSON
Active
Individual
DR. TONJANIKA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CPD0044
GA
101YP2500X
Professional Counselor
Primary
LPC006878
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518487529
NPI
GA
Enumeration date
12/03/2014
Last updated
11/30/2020
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