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1215637301
MARY MARIE JACKSON
ANDERSON, SC
NPI
1215637301
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: SC 27133)
Enumeration Date
2023-03-07
Last Update Date
2024-11-08
Business Address
MARY MARIE JACKSON PMHNP-BC
102 BUFORD AVE STE A
ANDERSON, SC 29621-3365
Phone number: 864-280-6551
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Mailing Address
MARY MARIE JACKSON PMHNP-BC
102 BUFORD AVE STE A
ANDERSON, SC 29621-3365
Phone number: 864-261-9506
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