Individual
MISS BAMBI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
8304 WOODIRON DR, DULUTH, GA 30097-3755
(770) 299-9752
Mailing address
8304 WOODIRON DR, DULUTH, GA 30097-3755
(770) 299-9752
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
06/09/2025
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