Provider Demographics
NPI:1114473766
Name:ROBINSON-JACKSON, EUGERE (BS)
Entity Type:Individual
Prefix:
First Name:EUGERE
Middle Name:
Last Name:ROBINSON-JACKSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 GOODWOOD BLVD
Mailing Address - Street 2:A1
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7740
Mailing Address - Country:US
Mailing Address - Phone:225-421-1921
Mailing Address - Fax:225-372-8649
Practice Address - Street 1:8211 GOODWOOD BLVD
Practice Address - Street 2:A1
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-421-1921
Practice Address - Fax:225-372-8649
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health