Individual
JOHNNIE JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4336 NORTH BLVD STE 204, BATON ROUGE, LA 70806-3920
(225) 960-7419
Mailing address
6644 DALARK DR, BATON ROUGE, LA 70812-1303
(225) 960-7419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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