Individual
MISS JESSICA NICOLE VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 MACKEY PL, SUITE 135, SHREVEPORT, LA 71118-2544
(318) 220-8423
(318) 220-8573
Mailing address
2715 MACKEY PL, SUITE 135, SHREVEPORT, LA 71118-2544
(318) 220-8423
(318) 220-8573
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2016
Last updated
11/01/2018
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