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Individual

KENYATTA AVERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4255 E BROOKSTOWN DR, BATON ROUGE, LA 70805-4603
(225) 291-9646
(225) 250-5677
Mailing address
4255 E BROOKSTOWN DR, BATON ROUGE, LA 70805-4603
(225) 250-5677

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9391
LA
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600751961
LA
Enumeration date
04/25/2016
Last updated
07/23/2025
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