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1417485855
LATOYA JACK
LAKE CHARLES, LA
NPI
1417485855
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-05-30
Last Update Date
2022-07-21
Business Address
LATOYA JACK
4396 GORDON WOODS DR
LAKE CHARLES, LA 70615-2997
Phone number: 337-215-0576
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Mailing Address
LATOYA JACK
4396 GORDON WOODS DR
LAKE CHARLES, LA 70615-2997
Phone number: 337-215-0576
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