Individual
MARSHALEE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 W PIKE ST STE 104, LAWRENCEVILLE, GA 30046-4966
(678) 770-6034
Mailing address
195 W PIKE ST STE 104, LAWRENCEVILLE, GA 30046-4966
(678) 770-6034
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010505
GA
Other
Enumeration date
11/29/2018
Last updated
05/23/2023
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