Chantalyn Jackson

NPI #1932651387 in Amite, Louisiana

Provider Information

NPI Number: 1932651387
Entity Type: Individual
Name: Chantalyn Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Nov 2, 2016
Last Updated: Nov 2, 2016

Practice Location

Address: 104 SASSAFRAS ST
City: Amite
State: Louisiana
ZIP Code: 70422-3425
Phone: (225) 644-8565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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