Individual
IVORY VEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A., MHS
Contact information
Practice address
5902 BUNCOMBE RD, SHREVEPORT, LA 71129
(318) 670-8898
(318) 300-3772
Mailing address
PO BOX 29372, SHREVEPORT, LA 71149-9372
(318) 670-8898
(318) 300-3772
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/29/2015
Last updated
07/13/2018
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