Individual
CRYSTAL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6305 ELYSIAN FIELDS AVE STE 404, NEW ORLEANS, LA 70122-4293
(504) 265-0996
Mailing address
5000 WOODLAND DR APT 207, NEW ORLEANS, LA 70131-7614
(504) 231-5496
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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