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1073230736
LARISSA JACKSON
ATHENS, GA
NPI
1073230736
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC009037)
Enumeration Date
2022-10-24
Last Update Date
2022-10-24
Business Address
LARISSA JACKSON MS
1720 LEXINGTON RD STE A
ATHENS, GA 30605-2330
Phone number: 706-543-3522
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Mailing Address
LARISSA JACKSON MS
1720 LEXINGTON RD STE A
ATHENS, GA 30605-2330
Phone number: 706-543-3522
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