Individual
DR. TATIA PATRICE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3448 PINEHILL DR, DECATUR, GA 30032-3031
(414) 732-8636
Mailing address
3448 PINEHILL DR, DECATUR, GA 30032-3031
(414) 732-8636
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
GA
372600000X
Adult Companion
—
GA
374U00000X
Home Health Aide
—
GA
376J00000X
Homemaker
—
GA
Other
Enumeration date
12/28/2019
Last updated
12/28/2019
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