Individual ProviderDoris Jean JeffersonCounselorBehavioral Health & Social Service ProvidersPractice Address204 Airport Rd, Vidalia, LA 71373-3449(318) 323-1300PECOS EnrollmentBased on the most recent information from CMS, provider Doris Jean Jefferson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:54 AM.Profile DetailsProvider ID1063936250Provider TypeIndividualFull NameJefferson, Doris JeanGenderFemaleSole ProprietorYesEnumeration Date7/28/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address204 Airport Rd, Vidalia, LA 71373-3449Phone(318) 323-1300Fax(318) 323-1400Mailing LocationMailing Address204 Airport Rd, Vidalia, LA 71373-3449Phone(318) 323-1300Fax(318) 323-1400Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerLouisiana