Individual
VALERIE CANNON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 N EXPRESSWAY STE B, GRIFFIN, GA 30223-1185
(678) 408-4622
Mailing address
1815 N EXPRESSWAY STE B, GRIFFIN, GA 30223-1185
(678) 408-4622
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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