Individual
JESSICA RENE GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6676 LAKERIDGE DRIVE, ZACHARY, LA 70791
(225) 772-5322
Mailing address
6676 LAKERIDGE DRIVE, ZACHARY, LA 70791
(225) 772-5322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11057
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
LA
Enumeration date
05/19/2017
Last updated
06/16/2018
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