Individual
AMIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5420 CORPORATE BLVD. STE 308, BATON ROUGE, LA 70808
(225) 364-2550
Mailing address
5420 CORPORATE BLVD STE 308, BATON ROUGE, LA 70808-2548
(225) 364-2550
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/27/2017
Last updated
07/21/2022
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