KERMIT JACKSON

BATON ROUGE, LA
NPI1568827228
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2015-12-23
Last Update Date2018-07-03
Business Address
KERMIT JACKSON
862 ONEAL LN
BATON ROUGE, LA 70816
Phone number: 225-362-4539
Mailing Address
KERMIT JACKSON
862 ONEAL LN
BATON ROUGE, LA 70816-1874
Phone number: 225-362-4539
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