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Individual

STEFANIE CHARISSE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
260 PEACHTREE ST NW STE 2200, ATLANTA, GA 30303-1292
(301) 392-7779
Mailing address
9846 LORI RD STE 201, CHESTERFIELD, VA 23832-6695

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001609
VA
106H00000X
Marriage & Family Therapist
MFT001862
GA
106H00000X
Marriage & Family Therapist
TPMF1187
FL

Other

Enumeration date
04/06/2020
Last updated
12/01/2025
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