Individual
MONIQUE A THIBODEAUX JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1418 BULLRUSH DR, BATON ROUGE, LA 70810-5222
(225) 603-4068
(225) 767-0203
Mailing address
1418 BULLRUSH DR, BATON ROUGE, LA 70810-5222
(225) 603-4068
(225) 767-0203
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5237
LA
Other
Enumeration date
11/23/2007
Last updated
07/21/2011
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