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1982146668
TROY A JACKSON
SHREVEPORT, LA
NPI
1982146668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2016-11-10
Last Update Date
2019-01-17
Business Address
Mr. TROY A JACKSON
1513 LINE AVE SUITE 222
SHREVEPORT, LA 71107-6503
Phone number: 318-208-8908
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Mailing Address
Mr. TROY A JACKSON
1513 LINE AVE SUITE 222
SHREVEPORT, LA 71101-6503
Phone number: 318-208-8908
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