Individual
KE'ARRAH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4266 WEST MAIN STREET SUITE 100, GRAY, LA 70359
(985) 360-8199
Mailing address
157 NATALIE PARK DR, THIBODAUX, LA 70301-8439
(985) 360-8199
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/01/2016
Last updated
06/26/2023
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