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1760857700
TALISHA JACKO
LAKE CHARLES, LA
NPI
1760857700
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2015-12-02
Last Update Date
2018-06-01
Business Address
TALISHA JACKO
840 W BAYOU PINES DR SUITE B
LAKE CHARLES, LA 70601
Phone number: 337-491-1740
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Mailing Address
TALISHA JACKO
840 W BAYOU PINES DR SUITE B
LAKE CHARLES, LA 70601-7495
Phone number: 337-491-1740
Copy
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