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1114528957
TAKELIA JACKSON
SMYRNA, GA
NPI
1114528957
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC011682)
Enumeration Date
2020-11-06
Last Update Date
2021-08-13
Business Address
TAKELIA JACKSON
2875 SPRING VILLA LN SE
SMYRNA, GA 30080-3644
Phone number: 678-592-1680
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Mailing Address
TAKELIA JACKSON
2875 SPRING VILLA LN SE
SMYRNA, GA 30080-3644
Phone number: 678-592-1680
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