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1861108573
MAYQUIE JACKSON
SHREVEPORT, LA
NPI
1861108573
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-01-25
Last Update Date
2023-01-25
Business Address
MAYQUIE JACKSON
103 BOULEVARD ST
SHREVEPORT, LA 71104-2503
Phone number: 318-895-6106
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Mailing Address
MAYQUIE JACKSON
103 BOULEVARD ST
SHREVEPORT, LA 71104-2503
Phone number: 318-895-6106
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