Individual
MARCUS GEORGE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3925 N I 10 SERVICE RD W STE 117, METAIRIE, LA 70002-6831
(504) 455-2446
Mailing address
3925 N I 10 SERVICE RD W STE 117, METAIRIE, LA 70002-6831
(504) 455-2446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
NA
LA
175T00000X
Peer Specialist
Primary
OBHPSS856
LA
Other
Enumeration date
01/18/2022
Last updated
05/31/2022
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