Individual
JESSICA LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6201 BERT KOUNS INDUSTRIAL LOOP LOT 645, SHREVEPORT, LA 71129-5046
(318) 401-8618
Mailing address
6201 BERT KOUNS INDUSTRIAL LOOP LOT 645, SHREVEPORT, LA 71129-5046
(318) 401-8618
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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