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Individual

MS. JACQUELINE YVETTE WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
116 LAUGHLIN DR, LOCUST GROVE, GA 30248-6015
(770) 833-2851
(770) 957-0522
Mailing address
116 LAUGHLIN DR, LOCUST GROVE, GA 30248-6015
(770) 833-2851
(888) 493-4555

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
737485550B
GA
Enumeration date
09/16/2009
Last updated
04/13/2015
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