Individual
REGINALD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOCIAL WORKER
Contact information
Practice address
7425 EDWARD ST, NEW ORLEANS, LA 70126-2013
(504) 813-6258
(504) 368-2180
Mailing address
PO BOX 872382, NEW ORLEANS, LA 70187-2382
(504) 813-6258
(504) 368-2180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4522
LA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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