Individual
CONDOLEEZZIA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1109 CARTER ST, VIDALIA, LA 71373-3227
(318) 336-4700
(318) 336-4777
Mailing address
1109 CARTER ST STE 10, VIDALIA, LA 71373-3227
(318) 336-4700
(318) 336-4777
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640897031
—
LA
Enumeration date
06/18/2018
Last updated
05/07/2019
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