Individual
MRS. DANA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 YOUREE DRIVE, SHREVEPORT, LA 71104
(318) 743-3408
Mailing address
6233 TRAILWOOD TER, SHREVEPORT, LA 71119-7232
(318) 584-2488
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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