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3633 Wheeler Rd Ste 100 Augusta GA 30909-6550 | |
| (706) 364-0252 | |
| (706) 364-0269 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3633 Wheeler Rd Ste 100, Augusta, Georgia |
| Authorized Official Name and Position | Tonjanika Jackson (OWNER) |
| Authorized Official Contact | 7063620252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3633 Wheeler Rd Ste 100 Augusta GA 30909-6550 Ph: (706) 364-0252 | 3633 Wheeler Rd Ste 100 Augusta GA 30909-6550 Ph: (706) 364-0252 |
| NPI Number | 1518487529 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518487529 | NPI | - | NPPES |
| 1821495961 | Other | GA | NPI |
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