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1174039119
FLORA A JACKSON
SHREVEPORT, LA
NPI
1174039119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-12-27
Last Update Date
2021-07-01
Business Address
FLORA A JACKSON
9403 MANSFIELD RD
SHREVEPORT, LA 71118-3815
Phone number: 318-861-8938
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Mailing Address
FLORA A JACKSON
4338 JOSEY CIR
SHREVEPORT, LA 71109-6614
Phone number:
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