Individual
SONNIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 DUCHESS DR, BATON ROUGE, LA 70815-2950
(225) 252-1927
Mailing address
1120 GOVERNMENT ST BLDG E, BATON ROUGE, LA 70802-4802
(225) 364-2550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/25/2017
Last updated
10/01/2018
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