Individual
JEANINE CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 WHITE INGRAM PKWY, DALLAS, GA 30132-0969
(678) 363-7447
Mailing address
6060 RIDGE WAY, DOUGLASVILLE, GA 30135-3734
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01787
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
GA
Other
Enumeration date
08/21/2023
Last updated
11/21/2023
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