Individual
COREY JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 MACARTHUR DR, SUNSET, LA 70584-6212
(337) 962-3737
Mailing address
311 MACARTHUR DR, SUNSET, LA 70584-6212
(337) 962-3737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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