Individual
DR. MARY H. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
ROUTE 1, METTER, GA 30439
(912) 685-6545
(912) 685-6545
Mailing address
RR 1 BOX 298, METTER, GA 30439-9703
(912) 685-6545
(912) 685-6545
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1843
GA
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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