Jackson, Demetria
Jackson, Demetria is an sole proprietor health care provider with primary practice located at 157 Coral Dr , Brunswick GA 31523-8951. 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, Demetria can be contacted via phone (912) 689-4382.Contact Information
Primary practice address
157 Coral Dr
Brunswick GA 31523-8951
Phone: (912) 689-4382
Fax: (888) 875-2884
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP007195 | Georgia |
Profile Details
| NPI number | 1790005791 |
|---|---|
| LBN Legal business name | Jackson, Demetria |
| Credentials | CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2010 |
| Last updated | Feb 4th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790005791 | NPPES |
| Georgia | MEDICAID | 658178836A |
Popular Providers
-
Lunsford, Susan Marshall
2415 Parkwood Dr , Brunswick GA 31520-4722 -
Hayes, Mary
2415 Parkwood Dr , Brunswick GA 31520-4722 -
Laidler, Royce K
2228 Starling St , Brunswick GA 31520-4200 -
Thompson, Ashley
3215 Shrine Rd Ste 12 , Brunswick GA 31520-4300 -
Lynema, Casey Cherie
110 Autumn Ridge Ct , Brunswick GA 31525-4746 -
Williamson, Renee J
117 Old Wharf Rd , Brunswick GA 31523-8943 -
Boykin, Shannon K
2228 Starling St , Brunswick GA 31520-4200 -
Goodman, Amanda L
182 Autumn Ridge Ct , Brunswick GA 31525-4746