Individual
JALISA D JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
915 WASHINGTON ST, FRANKLINTON, LA 70438-1718
(985) 322-2026
Mailing address
399 SAINT PAUL RD, TYLERTOWN, MS 39667-6162
(601) 337-2031
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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