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Individual

MS. PRISCILLA JACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LAPC, NCC

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6350
Mailing address
412 SPRING CREEK LN, ATLANTA, GA 30350-6502
(404) 234-9635

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC003287
GA

Other

Enumeration date
01/30/2013
Last updated
01/30/2013
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