THAD JACKSON

BATON ROUGE, LA
NPI1669988879
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2017-12-26
Last Update Date2018-06-16
Business Address
THAD JACKSON
449 BEN HUR RD APT 5106B
BATON ROUGE, LA 70820-4144
Phone number: 504-410-1976
Mailing Address
THAD JACKSON
449 BEN HUR RD APT 5106B
BATON ROUGE, LA 70820-4144
Phone number: 504-410-1976
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