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1356877120
SHANEL S. JACKSON
LAFAYETTE, LA
NPI
1356877120
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-05-11
Last Update Date
2019-05-15
Business Address
SHANEL S. JACKSON M.A.
113 W CONVENT ST
LAFAYETTE, LA 70501
Phone number: 337-534-0770
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Mailing Address
SHANEL S. JACKSON M.A.
113 W CONVENT ST
LAFAYETTE, LA 70501-6903
Phone number: 337-534-0770
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