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SHAWNA JACKSON

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1225531411

Individual Registrant:
 SHAWNA  JACKSON 
Gender: F
Sole Proprietor

Location and contact information for practice:
100 GLENDALOUGH CT STE E  TYRONE, GA 30290-2942 US
Tel: 770-683-9375  Fax: --

Contact information for business:
914 LAKESIDE WAY  NEWNAN, GA 30265-1191 US
Tel: 770-683-9375  Fax: --

Registration Information:
NPI: 1225531411
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor
GA5228

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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