Individual
VICKI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
200 GROVER TURNER WAY, MCDONOUGH, GA 30253-5976
(678) 371-6470
Mailing address
200 GROVER TURNER WAY, MCDONOUGH, GA 30253-5976
(678) 371-6470
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
146N00000X
Basic Emergency Medical Technician
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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