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1356985444
IDA JACKSON
MONROE, LA
NPI
1356985444
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-10-31
Last Update Date
2019-10-31
Business Address
IDA JACKSON
2808 EVANGELINE ST
MONROE, LA 71201-3750
Phone number: 318-325-9503
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Mailing Address
IDA JACKSON
2808 EVANGELINE ST
MONROE, LA 71201-3750
Phone number:
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