Individual
ASHLEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1648 CARTER ST, VIDALIA, LA 71373-3111
(318) 734-0034
(318) 734-0035
Mailing address
1648 CARTER ST, VIDALIA, LA 71373-3111
(318) 734-0034
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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