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General NPI Number Information
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NPI Number | 1093638595
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Entity Type | Individual
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Provider Name | KRYSTAL TOMSKY-JACKSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2026
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Last Update Date | 08/01/2026
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Provider Practice Location Address
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Address Line | 190 W CAMPGROUND RD
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City | MCDONOUGH
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State | GA
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Zip | 30253-8034
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Country | US
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Telephone | 404-689-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 128 KING RICHARD DR
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City | GRIFFIN
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State | GA
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Zip | 30223-8812
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Country | US
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Telephone | 478-213-3690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY900332
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY900332
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License Number State | GA
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