Individual
BERTHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6224 SHENFIELD LN, UNION CITY, GA 30291-7117
(470) 236-8813
Mailing address
6224 SHENFIELD LN, UNION CITY, GA 30291-7117
(470) 236-8813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW008840
GA
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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