Individual
JACKSON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1270 PRINCE AVE STE 201, ATHENS, GA 30606-2789
(706) 475-7055
Mailing address
190 ROLLINGWOOD DR, ATHENS, GA 30605-3328
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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