Individual
KELLY KENDRICK BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-1479
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-1479
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6581
LA
Other
Enumeration date
12/19/2011
Last updated
12/20/2011
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