Individual
MR. FRED JACKSON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1155 BROOKWOOD DR, EASTMAN, GA 31023-7536
(478) 278-7585
Mailing address
1155 BROOKWOOD DR, EASTMAN, GA 31023-7536
(478) 278-7585
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004399
GA
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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