Individual
DIJUAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
631 MILAM ST STE 103, SHREVEPORT, LA 71101-3534
(318) 658-0069
Mailing address
1 TIGER DR, MARSHALL, TX 75670-1412
(903) 923-2360
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/06/2020
Last updated
10/23/2025
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