Individual
ASHLEY BRE'ANN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
609 S VIENNA ST, RUSTON, LA 71270-5038
(318) 455-1163
Mailing address
1000 CHINABERRY DR STE 903, BOSSIER CITY, LA 71111-2455
(318) 459-6795
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
02/28/2022
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