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1053851063
ANDRIA DANIELL JACKSON
BOSSIER CITY, LA
NPI
1053851063
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-02-24
Last Update Date
2021-07-12
Business Address
ANDRIA DANIELL JACKSON
1000 CHINABERRY DR STE 900
BOSSIER CITY, LA 71111-2455
Phone number: 318-259-4676
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Mailing Address
ANDRIA DANIELL JACKSON
1616 ARKANSAS RD APT 169
WEST MONROE, LA 71291-7042
Phone number: 210-880-2621
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