Individual
MARCUS DEVAUGHN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 GLADYS HODGE RD, HOMER, LA 71040-5447
(318) 245-9176
Mailing address
221 GLADYS HODGE RD, HOMER, LA 71040-5447
(318) 245-9176
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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