Individual
MISS DANIELLE LYNETTE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 BRES AVE, MONROE, LA 71201-5860
(318) 509-8073
Mailing address
2515 KAVANAUGH RD APT 25, RUSTON, LA 71270-9542
(318) 243-7683
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
01/29/2018
Last updated
06/06/2019
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