Individual
JARVIS GERARD SHANKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3135 HIGHWAY 1, RACELAND, LA 70394-3652
(985) 413-2280
Mailing address
PO BOX 5022, THIBODAUX, LA 70302-5022
(985) 413-2280
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6014
LA
Other
Enumeration date
08/13/2011
Last updated
01/06/2015
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