Individual
DR. JACKSON K EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMIN., LCSW
Contact information
Practice address
650 HENDERSON DR STE 430, CARTERSVILLE, GA 30120-3760
(404) 334-5859
Mailing address
1275 SHILOH RD NW STE 3030, KENNESAW, GA 30144-7186
(404) 334-5859
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW006645
GA
1041C0700X
Clinical Social Worker
Primary
CSW006235
GA
Other
Enumeration date
08/11/2015
Last updated
06/26/2018
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