EVIAN MICHELLE JACKSON

BATON ROUGE, LA
NPI1932682358
Former NameEVIAN MICHELLE GOODE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: LA  8233)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-09-11
Last Update Date2022-08-08
Business Address
Mrs. EVIAN MICHELLE JACKSON
4055 PRESCOTT RD
BATON ROUGE, LA 70805-5146
Phone number: 225-372-2037
Mailing Address
Mrs. EVIAN MICHELLE JACKSON
9655 JUDI AVE
BATON ROUGE, LA 70815-4923
Phone number: 225-938-4445