Provider Information for 1972692796
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VICKIE M JESTER LCSW
Sex: Female
NPI: 1972692796
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1972692796 | ||||||||
| Enumeration Date | 2006-10-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2029 MARK TRL DECATUR, GA 30032-5350 United States Phone: 404-377-7052 | Fax: | ||||||||
| Primary Practice Address | 1636 CONNALLY DR EAST POINT, GA 30344-2558 United States Phone: 404-762-4042 | Fax: | ||||||||
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