MR. Clinton Wayne Jackson JR., LCSW
NPI #1346416955 in Fort Moore, Georgia
Provider Information
- NPI Number
- 1346416955
- Entity Type
- Individual
- Name
- MR. Clinton Wayne Jackson JR., LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker
- Credential
- LCSW
- Enumeration Date
- May 3, 2008
- Last Updated
- Sep 22, 2023
Practice Location
- Address
- 6600 VAN AALST BLVD
- City
- Fort Moore
- State
- Georgia
- ZIP Code
- 31905-2102
- Phone
- (762) 408-4065
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
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