Individual
MACHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8423A OLD STATE RD, HOLLY HILL, SC 29059-8880
(803) 496-3324
Mailing address
2319 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-2042
(803) 536-1571
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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