Jackson, Mary Sonya
Jackson, Mary Sonya is an individual health care provider with primary practice located at 5480 Hedge Brooke Pointe Nw , Acworth GA 30101-7142. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Home Modifications, Other Service Providers / Peer Specialist, Other Service Providers / Contractor. Other Service Providers / Contractor is her primary health care specialty. Jackson, Mary Sonya can be contacted via phone (404) 960-5486.Contact Information
Primary practice address
5480 Hedge Brooke Pointe Nw
Acworth GA 30101-7142
Phone: (404) 960-5486
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Home Modifications | 171WH0202X | NTO15850 | |
| Other Service Providers / Peer Specialist | 175T00000X | ||
| Other Service Providers / Contractor | 171W00000X | NTO15850 | Georgia |
Profile Details
| NPI number | 1922605690 |
|---|---|
| LBN Legal business name | Jackson, Mary Sonya |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2020 |
| Last updated | Oct 6th, 2020 - about 6 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 | 1922605690 | NPPES |
| Georgia | Other | 00000000 | N/A |
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