Jackson, Dominique
Jackson, Dominique is an individual health care provider with primary practice located at 5330 Rutland Ct , Powder Springs GA 30127-4785. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Jackson, Dominique can be contacted via phone (404) 913-6337.Contact Information
Primary practice address
5330 Rutland Ct
Powder Springs GA 30127-4785
Phone: (404) 913-6337
Fax: (404) 393-7473
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1699544783 |
|---|---|
| LBN Legal business name | Jackson, Dominique |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2023 |
| Last updated | Dec 29th, 2023 - about last year |
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.
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