Jackson, Michelle A

Jackson, Michelle A is an individual health care provider with primary practice located at 2020 Peachtree Rd Nw , Atlanta GA 30309-1426. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Jackson, Michelle A can be contacted via phone (404) 367-1310.

Contact Information

Primary practice address
2020 Peachtree Rd Nw Atlanta GA 30309-1426
Phone: (404) 367-1310
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY004033 Georgia

Profile Details

NPI number 1346553021
LBN Legal business name Jackson, Michelle A
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2010
Last updated Jan 31st, 2018 - about 7 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 1346553021 NPPES
Massachusetts MEDICAID 110026265E
Massachusetts Other 685661

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