Individual
ALFREDA T JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
833 W MAIN ST, NEW IBERIA, LA 70560-3535
(337) 519-1682
Mailing address
833 W MAIN ST, NEW IBERIA, LA 70560-3535
(337) 519-1682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6547
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/01/2015
Last updated
08/06/2024
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