MS. Tanisha Jackson

NPI #1407311509 in Lagrange, Georgia

Provider Information

NPI Number
1407311509
Entity Type
Individual
Name
MS. Tanisha Jackson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Case Manager/Care Coordinator
Enumeration Date
Feb 4, 2019
Last Updated
Feb 4, 2019

Practice Location

Address
1271 HOGANSVILLE RD APT 115
State
Georgia
ZIP Code
30241-6667
Phone
(334) 646-1574

Specialties & Taxonomy Codes

Specialty
Case Manager/Care Coordinator

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