Healthcare Provider Details

I. General information

NPI: 1194648105
Provider Name (Legal Business Name): MRS. CHERENE A JARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 LOWER JERSEY RD
OXFORD GA
30054-3102
US

IV. Provider business mailing address

4901 LOWER JERSEY RD
OXFORD GA
30054-3102
US

V. Phone/Fax

Practice location:
  • Phone: 808-203-4152
  • Fax:
Mailing address:
  • Phone: 808-203-4152
  • Fax: 808-203-4152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: