Individual
CHELLCY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1162 OLIVER RD STE 4, MONROE, LA 71201-5757
(318) 340-1535
(318) 340-1539
Mailing address
850 KALISTE SALOOM RD STE 117, LAFAYETTE, LA 70508-4230
(337) 234-7109
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
12/02/2016
Last updated
10/04/2024
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