Individual
MARY D JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-BAC
Contact information
Practice address
24120 PLANK RD, ZACHARY, LA 70791-6430
(225) 620-4132
Mailing address
24120 PLANK RD, ZACHARY, LA 70791-6430
(225) 620-4132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12783
LA
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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