Individual
CHEMARA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., LPC
Contact information
Practice address
4845 LOCHERBY DR, FAIRBURN, GA 30213-4385
(404) 754-2989
Mailing address
4845 LOCHERBY DR, FAIRBURN, GA 30213-4385
(404) 754-2989
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003140046A
—
GA
Enumeration date
12/11/2014
Last updated
01/23/2017
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