Individual
MAHKADA TAYLOR JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1420 RIDGEBEND WAY SE, MABLETON, GA 30126
(646) 731-4785
Mailing address
1420 RIDGEBEND WAY SE, MABLETON, GA 30126
(646) 731-4785
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY004135
GA
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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