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Individual

MARIANNE JACKSON SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CPHT, ATS, CRTS

Contact information

Practice address
639 IRVIN ST, CORNELIA, GA 30531-3267
(706) 778-4918
(706) 776-2502
Mailing address
PO BOX 99, CORNELIA, GA 30531-0099
(706) 778-7369
(706) 776-2502

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
150101586580537
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
1002338

Other

Enumeration date
01/20/2006
Last updated
09/11/2025
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