| NPI | 1912230129 |
|---|---|
| Former Name | SUSAN HOLLY BESSON JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 2477) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC002609) |
| 101YP2500X Counselor, Professional (Licence: GA 002609) | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2015-03-17 |