Individual
MS. PHYLLIS JACKSON-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2995 MEADOW LARK DR, EAST POINT, GA 30344-4033
(404) 762-7859
(404) 762-7859
Mailing address
2995 MEADOW LARK DR, EAST POINT, GA 30344-4033
(404) 762-7859
(404) 762-7859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW1122
GA
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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