Individual
ANGEL HEART JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
111 MEDICAL PARK DR, LAFAYETTE, LA 70508-4500
(337) 269-5000
(337) 269-5001
Mailing address
111 MEDICAL PARK DR, LAFAYETTE, LA 70508-4500
(337) 269-5000
(337) 269-5001
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
17884
LA
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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