Individual
CRYSTAL DENISE KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 JAMESTOWN ST UNIT J, LAKE CHARLES, LA 70605-5711
(337) 603-7892
Mailing address
125 JAMESTOWN ST UNIT J, LAKE CHARLES, LA 70605-5711
(337) 603-7892
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
007683671
LA
247200000X
Other Technician
Primary
007683671
LA
Other
Enumeration date
04/02/2026
Last updated
04/24/2026
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