Individual
LATASHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11607 SOUTHFORK AVE BLDG B, BATON ROUGE, LA 70816-5220
(877) 418-2978
(866) 500-2188
Mailing address
3236 VANCOUVER DR, BATON ROUGE, LA 70819-1853
(877) 418-2978
(866) 500-2188
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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