Jackson, Celeste
Jackson, Celeste is an individual health care provider with primary practice located at 4220 Stackstone Dr , Cumming GA 30041-5644. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jackson, Celeste can be contacted via phone (404) 641-9019.Contact Information
Primary practice address
4220 Stackstone Dr
Cumming GA 30041-5644
Phone: (404) 641-9019
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP004817 | Georgia |
Profile Details
| NPI number | 1255389649 |
|---|---|
| LBN Legal business name | Jackson, Celeste |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255389649 | NPPES |
| Georgia | MEDICAID | 00836998B |
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