Individual
JERRY PICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
(318) 862-3554
Mailing address
411 SUMMIT ST, MINDEN, LA 71055-2837
(313) 718-8829
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2013
Last updated
06/03/2020
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