Russell Jermain Patterson, MA
Counselor in Jonesboro, GA. Individual provider (NPI-1).
NPI number1689375412
StatusActive
Last updated in NPPESMar 17, 2023
Details
- NPI
- 1689375412
- Entity type
- Individual (NPI-1)
- Name
- Mr. Russell Jermain Patterson
- Credential
- MA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 17, 2023
- Certification date
- Mar 17, 2023
- Last updated
- Mar 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
124 S Main St Ste 218Jonesboro, GA 30236-3599
Phone 678-215-8705
Mailing address
4732 Huntsman BndDecatur, GA 30034-2505
Phone 404-447-1686
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