WILLIAM JACKSON

SHREVEPORT, LA
NPI1558848838
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2018-07-19
Last Update Date2019-06-12
Business Address
WILLIAM JACKSON
7330 FERN AVE STE 1102
SHREVEPORT, LA 71105-4989
Phone number: 318-524-9954
Mailing Address
WILLIAM JACKSON
7330 FERN AVE STE 1102
SHREVEPORT, LA 71105-4989
Phone number:
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