Individual
JALISA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3308 TULANE AVE STE 407, NEW ORLEANS, LA 70119-7158
(504) 821-6830
Mailing address
3401 GARDEN OAKS DR APT 218, NEW ORLEANS, LA 70114-7717
(504) 317-6417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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