FREDERICK J JACKSON

SHREVEPORT, LA
NPI1609222058
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2016-05-04
Last Update Date2024-05-30
Business Address
FREDERICK J JACKSON MS.
9045 KINGSTON RD APT 101
SHREVEPORT, LA 71118-3400
Phone number: 940-399-4095
Mailing Address
FREDERICK J JACKSON MS.
9045 KINGSTON RD APT 101
SHREVEPORT, LA 71118-3400
Phone number: 318-762-7425
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