Individual
LISA M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
210 MEDICAL DR, NATCHITOCHES, LA 71457-6052
(318) 357-3122
Mailing address
408 JOHN WATLEY RD, NATCHITOCHES, LA 71457-7021
(318) 332-3502
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7749
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/08/2016
Last updated
04/29/2022
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