Individual
JESSICA BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 364-1404
Mailing address
3643 WALTON WAY EXT BLDG 4, AUGUSTA, GA 30909-6677
(706) 364-1404
(706) 364-1419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103224312
DRIVERS LICENSE
SC
05
—
421504
—
SC
Enumeration date
01/09/2014
Last updated
10/08/2018
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