Individual
MS. CHARNEL LAZETTE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4787 WAYWOOD DR, #C, ZACHARY, LA 70791-2480
(225) 654-6321
Mailing address
6820 CELIA DR, BATON ROUGE, LA 70811-1133
(225) 235-6281
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3661
LA
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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