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1730564279
EBONY CONERLY JACKSON
DENHAM SPRINGS, LA
NPI
1730564279
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: LA 9158)
Enumeration Date
2015-07-27
Last Update Date
2015-07-27
Business Address
EBONY CONERLY JACKSON LCSW, BACS
23791 SOUTHPOINT DR
DENHAM SPRINGS, LA 70726-6856
Phone number: 225-284-6249
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Mailing Address
EBONY CONERLY JACKSON LCSW, BACS
23791 SOUTHPOINT DR
DENHAM SPRINGS, LA 70726-6856
Phone number: 225-284-6249
Copy
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