Individual provider · Type 1 NPI
Dewanda B. Jackson, LPC, CPCS, EAU-C
Professional Counselor · Decatur, GA
NPI number
1184761561
Active
Practice location
4319 Covington Hwy Ste 110
Decatur, GA 30035-1206
Fax (404) 286-0064
Mailing address
PO Box 1501
Lithonia, GA 30058-1007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC002390 (GA) |
Professional Counselor: Definition to come...
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About NPI 1184761561
Dewanda B. Jackson, LPC, CPCS, EAU-C's National Provider Identifier is 1184761561, issued on Feb 1, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Decatur, GA. The record was last updated on Jun 23, 2021.