Individual
DR. STACEY LAJUNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 EAGLES WALK, STE. 100, STOCKBRIDGE, GA 30281-7204
(770) 507-6044
(770) 507-5284
Mailing address
110 EAGLES WALK, STE. 100, STOCKBRIDGE, GA 30281-7204
(770) 507-6044
(770) 507-5284
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY003073
GA
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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