Individual
ASHA NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
118 W 10TH ST, RESERVE, LA 70084-6202
(985) 536-1106
Mailing address
118 W 10TH ST, RESERVE, LA 70084-6202
(985) 536-1106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9959
LA
Other
Enumeration date
08/13/2025
Last updated
08/29/2025
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