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1518997196
TRACIE DENEICE JACKSON
SHREVEPORT, LA
NPI
1518997196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: LA 3384)
Enumeration Date
2006-07-03
Last Update Date
2007-07-08
Business Address
Ms. TRACIE DENEICE JACKSON MA, PC2
6005 FINANCIAL PLZ
SHREVEPORT, LA 71129-2615
Phone number: 318-632-2040
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Mailing Address
Ms. TRACIE DENEICE JACKSON MA, PC2
6005 FINANCIAL PLZ
SHREVEPORT, LA 71129-2615
Phone number: 318-632-2040
Copy
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