Individual
JESSICA RAE HATHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
740 CAMERON M ALEXANDER BLVD NW, ATLANTA, GA 30318-6812
(813) 362-0340
Mailing address
784 PONCE DE LEON PL NE APT 103, ATLANTA, GA 30306-4152
(813) 362-0340
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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