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1194196204
KEYANA DESHAWN JACKSON
BATON ROUGE, LA
NPI
1194196204
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 5941)
Enumeration Date
2015-10-14
Last Update Date
2019-12-30
Business Address
KEYANA DESHAWN JACKSON LPC, NBCC
4041 DAYTONA AVE
BATON ROUGE, LA 70814
Phone number: 225-933-5091
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Mailing Address
KEYANA DESHAWN JACKSON LPC, NBCC
4041 DAYTONA AVE
BATON ROUGE, LA 70814-7145
Phone number: 225-933-5091
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