Individual
MELVIN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1018 CAMPBELL AVE, VILLE PLATTE, LA 70586-8555
(337) 459-4209
Mailing address
1018 CAMPBELL AVE, VILLE PLATTE, LA 70586-8555
(337) 459-4209
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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