Individual
ANDREA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAPC
Contact information
Practice address
250 GEORGIA AVE SE STE 206, ATLANTA, GA 30312-3000
(404) 653-0374
Mailing address
45 HENLEY LN, NEWNAN, GA 30263-6909
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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