BRIAN JACKSON

SHREVEPORT, LA
NPI1346610011
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2015-10-06
Last Update Date2018-05-15
Business Address
BRIAN JACKSON
3008 CONMAR ST
SHREVEPORT, LA 71108
Phone number: 318-272-9721
Mailing Address
BRIAN JACKSON
3008 CONMAR ST
SHREVEPORT, LA 71108-3604
Phone number: 318-272-9721
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