Individual
ANGELA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 MAIN ST, MINDEN, LA 71055-3363
(318) 639-9543
Mailing address
3018 OLD MINDEN RD STE 1117, BOSSIER CITY, LA 71112-2497
(318) 746-1935
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/21/2017
Last updated
01/08/2020
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