Individual
MRS. SARAH L. JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD., LDN.
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 259-4998
Mailing address
5120 JACKSON RD, MORVEN, GA 31638-3931
(229) 259-4998
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
135
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00705383A
—
GA
Enumeration date
06/08/2006
Last updated
07/09/2007
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