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1215411343
AVERY JACK
BATON ROUGE, LA
NPI
1215411343
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-09-25
Last Update Date
2018-09-25
Business Address
AVERY JACK
9420 LINDALE AVE STE B
BATON ROUGE, LA 70815
Phone number: 225-442-3540
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Mailing Address
AVERY JACK
9420 LINDALE AVE STE B
BATON ROUGE, LA 70815-4161
Phone number: 225-442-3540
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