Individual
IVORY HEADSPETH MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
906 C M FAGAN DR BLDG A, HAMMOND, LA 70403-6056
(985) 956-7370
(985) 956-7371
Mailing address
906 C M FAGAN DR BLDG A, HAMMOND, LA 70403-6056
(985) 956-7370
(985) 956-7371
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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