Individual
GERELLE G JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3173 WASHINGTON AVE, BATON ROUGE, LA 70802-2178
(225) 778-7678
(225) 341-6825
Mailing address
3173 WASHINGTON AVE, BATON ROUGE, LA 70802-2178
(225) 778-7678
(225) 341-6825
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
02/06/2019
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