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Individual

KIMBERLY D. JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
270 CREEKVIEW BLVD, COVINGTON, GA 30016-7693
(404) 434-9595
(770) 787-9345
Mailing address
270 CREEKVIEW BLVD, COVINGTON, GA 30016-7693
(404) 434-9595
(770) 787-9345

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008106
GA

Other

Enumeration date
04/03/2013
Last updated
04/11/2013
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