Individual
MRS. WEALTHIA LYNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED SCHOOL PSYC
Contact information
Practice address
11115 SANDWOOD DR, KEITHVILLE, LA 71047-8345
(318) 393-6935
Mailing address
11115 SANDWOOD DR, KEITHVILLE, LA 71047-8345
(318) 393-6935
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
LSSP009
LA
Other
Enumeration date
08/04/2017
Last updated
07/21/2022
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