Individual
DEBRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
47 BIRCH ST, HIRAM, GA 30141-4128
(443) 471-6908
Mailing address
47 BIRCH ST, HIRAM, GA 30141-4128
(443) 471-6908
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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