Jackson, Celeste

Jackson, Celeste is an individual health care provider with primary practice located at 4220 Stackstone Dr , Cumming GA 30041-5644. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jackson, Celeste can be contacted via phone (404) 641-9019.

Contact Information

Primary practice address
4220 Stackstone Dr Cumming GA 30041-5644
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP004817 Georgia

Profile Details

NPI number 1255389649
LBN Legal business name Jackson, Celeste
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1255389649 NPPES
Georgia MEDICAID 00836998B

Popular Providers