Individual
LORRAINE T. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP/CCC
Contact information
Practice address
6600 PEACHTREE DUNWOODY RD, BLDG. 400 STE 125, ATLANTA, GA 30328-6773
(866) 587-9922
Mailing address
89 NORTHSHORE DR, LAGRANGE, GA 30240-9167
(706) 881-0901
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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