Individual
MR. GEORGE DARRYL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30045-8444
(770) 339-2289
(770) 339-5016
Mailing address
175 GWINNETT DR, P. O. BOX 687, LAWRENCEVILLE, GA 30045-8444
(770) 339-2289
(770) 339-5016
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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