Individual
MRS. JARRETT ROUX JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
3756 LAVISTA RD, SUITE 104, TUCKER, GA 30084-5614
(404) 477-9400
Mailing address
3756 LAVISTA RD, SUITE 104, TUCKER, GA 30084-5614
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
007403
GA
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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