Jackson, Mary Sonya

Jackson, Mary Sonya is an individual health care provider with primary practice located at 5480 Hedge Brooke Pointe Nw , Acworth GA 30101-7142. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Home Modifications, Other Service Providers / Peer Specialist, Other Service Providers / Contractor. Other Service Providers / Contractor is her primary health care specialty. Jackson, Mary Sonya can be contacted via phone (404) 960-5486.

Contact Information

Primary practice address
5480 Hedge Brooke Pointe Nw Acworth GA 30101-7142
Phone: (404) 960-5486
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Home Modifications 171WH0202X NTO15850
Other Service Providers / Peer Specialist 175T00000X
Other Service Providers / Contractor 171W00000X NTO15850 Georgia

Profile Details

NPI number 1922605690
LBN Legal business name Jackson, Mary Sonya
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2020
Last updated Oct 6th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922605690 NPPES
Georgia Other 00000000 N/A

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