Individual
GABRIELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3205 NEW HIGHWAY 51, LA PLACE, LA 70068-6513
(985) 652-1809
Mailing address
3205 NEW HIGHWAY 51 STE C, LA PLACE, LA 70068-6512
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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