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1225531411
SHAWNA JACKSON
TYRONE, GA
NPI
1225531411
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: GA 5228)
Enumeration Date
2018-03-14
Last Update Date
2018-03-14
Business Address
SHAWNA JACKSON
100 GLENDALOUGH CT STE E
TYRONE, GA 30290-2942
Phone number: 770-683-9375
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Mailing Address
SHAWNA JACKSON
914 LAKESIDE WAY
NEWNAN, GA 30265-1191
Phone number: 770-683-9375
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