Search › Georgia › 1041C0700X
Tyler-Leah Jackson, LCSW
NPI 1245900919 · on the registry since 2021 · sole proprietor
Practice
- Address
- 3931 Lake Manor Way
Atlanta, GA 30349 - Phone
- (571) 205-4080
Additional practice sites
- 2130 Kingston Ct Se Ste E, Marietta, GA
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 104100000X
1041C0700X - Licence states on file
- GA, DE
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-11-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia