AVERY JACK

BATON ROUGE, LA
NPI1215411343
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2018-09-25
Last Update Date2018-09-25
Business Address
AVERY JACK
9420 LINDALE AVE STE B
BATON ROUGE, LA 70815
Phone number: 225-442-3540
Mailing Address
AVERY JACK
9420 LINDALE AVE STE B
BATON ROUGE, LA 70815-4161
Phone number: 225-442-3540