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Individual

LIONEL JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
906 CM FAGAN DR. SUITE 3B, HAMMOND, LA 70403
(985) 542-1191
(985) 400-5417
Mailing address
69 WHITMAR DR, HAMMOND, LA 70401-1089

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
LA

Other

Enumeration date
01/07/2026
Last updated
01/07/2026
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