Individual
MR. CLINTON WAYNE JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(762) 408-4065
Mailing address
MARTIN ARMY COMMUNITY HOSPITAL, 6600 VAN AALST BOULEVARD, FORT MOORE, GA 31905
(762) 408-4065
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW004875
GA
104100000X
Social Worker
—
—
Other
Enumeration date
05/03/2008
Last updated
09/22/2023
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