Individual
LASONYA Z JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
175 MORNING SPRINGS WALK, FAYETTEVILLE, GA 30214-2664
(404) 484-4222
Mailing address
175 MORNING SPRINGS WALK, FAYETTEVILLE, GA 30214-2664
(404) 484-4222
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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