Individual
JAMES DAVID JERNIGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3120 N OAK STREET EXT STE C, VALDOSTA, GA 31602-5910
(229) 896-4559
Mailing address
3120 N OAK STREET EXT STE C, VALDOSTA, GA 31602-5910
(229) 896-4559
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1388
1388
GA
Enumeration date
04/20/2015
Last updated
04/20/2015
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