Individual
MRS. CHANDRA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC, NCSC
Contact information
Practice address
1224 STOKLEY PL, BATON ROUGE, LA 70815-7030
(225) 803-4802
Mailing address
1224 STOKLEY PL, BATON ROUGE, LA 70815-7030
(225) 803-4802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6459
LA
Other
Enumeration date
07/23/2018
Last updated
02/18/2019
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