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1316394141
JACQUELLE JACKSON
SHREVEPORT, LA
NPI
1316394141
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2016-05-23
Last Update Date
2018-11-20
Business Address
JACQUELLE JACKSON
331 MILAM ST
SHREVEPORT, LA 71101
Phone number: 318-213-0904
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Mailing Address
JACQUELLE JACKSON
9730 BAIRD RD APT 2310
SHREVEPORT, LA 71118-3879
Phone number: 318-560-2311
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