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1114306016
BIANCA JACKSON
BATON ROUGE, LA
NPI
1114306016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
Additional Taxonomies
222Q00000X Developmental Therapist
Enumeration Date
2015-05-26
Last Update Date
2019-07-31
Business Address
BIANCA JACKSON
1832 STANOCOLA DR
BATON ROUGE, LA 70807-3047
Phone number: 225-614-6773
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Mailing Address
BIANCA JACKSON
1832 STANOCOLA DR
BATON ROUGE, LA 70807-3047
Phone number: 225-614-6773
Copy
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