MODEACON LATRELL JACKSON

MONROE, LA
NPI1891208823
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2017-11-13
Last Update Date2018-03-17
Business Address
MODEACON LATRELL JACKSON
1702 BERNSTEIN PARK RD
MONROE, LA 71202-5502
Phone number: 318-331-3440
Mailing Address
MODEACON LATRELL JACKSON
1702 BERNSTEIN PARK RD
MONROE, LA 71202-5502
Phone number: 318-331-3440
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