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1003126962
EMILY BROCKETT JACKSON
DECATUR, GA
NPI
1003126962
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC1900X Psychologist, Counseling
(Licence: GA PSY003380)
Enumeration Date
2010-10-13
Last Update Date
2010-10-13
Business Address
Dr. EMILY BROCKETT JACKSON PhD
1670 CLAIRMONT ROAD ATLANTA VA MEDICAL CENTER
DECATUR, GA 30033
Phone number: 404-429-0419
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Mailing Address
Dr. EMILY BROCKETT JACKSON PhD
15 CARDINAL CT
STOCKBRIDGE, GA 30281-1785
Phone number: 404-429-0419
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