Reagen Jackson

NPI #1063060424 in Lithonia, Georgia

Provider Information

NPI Number: 1063060424
Entity Type: Individual
Name: Reagen Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 29, 2019
Last Updated: Aug 29, 2019

Practice Location

Address: 7301 FAIRINGTON RIDGE CIR
City: Lithonia
State: Georgia
ZIP Code: 30038-5612
Phone: (678) 421-4516

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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