Staci Nicole Jackson
NPI #1003329160 in Baton Rouge, Louisiana
Provider Information
- NPI Number
- 1003329160
- Entity Type
- Individual
- Name
- Staci Nicole Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Nov 13, 2017
- Last Updated
- Nov 13, 2017
Practice Location
- Address
- 11616 SOUTHFORK AVE
- City
- Baton Rouge
- State
- Louisiana
- ZIP Code
- 70816-5241
- Phone
- (225) 291-9646
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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