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1497507420
KATRECE SHANTELLE JACKSON
MONROE, LA
NPI
1497507420
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA CIT5775)
Enumeration Date
2024-04-03
Last Update Date
2024-04-03
Business Address
KATRECE SHANTELLE JACKSON
1401 HUDSON LN STE 202
MONROE, LA 71201-6032
Phone number: 318-323-1300
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Mailing Address
KATRECE SHANTELLE JACKSON
1401 HUDSON LN STE 202
MONROE, LA 71201-6032
Phone number: 318-323-1300
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