Individual
SHAKIATRA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1727 BOXWOOD PL, COLUMBUS, GA 31906-2328
(706) 569-0727
Mailing address
1110 13TH ST # D, COLUMBUS, GA 31901-2246
(706) 780-1704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC008775
GA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/04/2022
Last updated
01/09/2023
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