Individual
FELICIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3018 OLD MINDEN RD STE 1117, BOSSIER CITY, LA 71112
(318) 746-1935
Mailing address
3018 OLD MINDEN RD STE 1117, BOSSIER CITY, LA 71112-2497
(318) 746-1935
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/21/2015
Last updated
06/05/2018
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