Individual
CANDYCE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 COMMERCIAL DR, HAMMOND, LA 70403-5954
(985) 662-3799
Mailing address
1102 COMMERCIAL DR, HAMMOND, LA 70403-5954
(985) 662-3799
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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