Individual
CARREYON E JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 CYNTHIA ST, WESTWEGO, LA 70094-5808
(504) 357-4167
Mailing address
46 CYNTHIA ST, WESTWEGO, LA 70094-5808
(504) 357-4167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
01/04/2023
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