Jackson, Reagen
Jackson, Reagen is an sole proprietor health care provider with primary practice located at 7301 Fairington Ridge Cir , Lithonia GA 30038-5612. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Reagen can be contacted via phone (678) 421-4516.Contact Information
Primary practice address
7301 Fairington Ridge Cir
Lithonia GA 30038-5612
Phone: (678) 421-4516
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1063060424 |
|---|---|
| LBN Legal business name | Jackson, Reagen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2019 |
| Last updated | Aug 29th, 2019 - about 5 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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