Individual
ANDRIA DANIELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 259-4676
Mailing address
1616 ARKANSAS RD APT 169, WEST MONROE, LA 71291-7042
(210) 880-2621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/24/2017
Last updated
07/12/2021
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