JACKIE HORNBECK WALL

DECATUR, GA
NPI1487242335
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: GA  LPC010696)
Additional Taxonomies101Y00000X Counselor
(Licence: GA  LPC010696)
Enumeration Date2021-01-06
Last Update Date2021-01-06
Business Address
JACKIE HORNBECK WALL LPC
317 W HILL ST STE 204A
DECATUR, GA 30030-4367
Phone number: 404-518-3524
Mailing Address
JACKIE HORNBECK WALL LPC
315 ADAMS ST
DECATUR, GA 30030-5205
Phone number: 404-518-3524