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1417406380
JAMES JACKSON
LAKE PROVIDENCE, LA
NPI
1417406380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-10-03
Last Update Date
2016-10-03
Business Address
-- JAMES JACKSON
1700 LAKE ST
LAKE PROVIDENCE, LA 71254-5208
Phone number: 318-559-0551
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Mailing Address
-- JAMES JACKSON
1700 LAKE ST
LAKE PROVIDENCE, LA 71254-5208
Phone number: 318-559-0551
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