Individual
ALICIA SHAVELLE BLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
128 LOUISIANA AVE, FERRIDAY, LA 71334-2826
(318) 437-7157
(318) 437-7158
Mailing address
128 LOUISIANA AVE, FERRIDAY, LA 71334-2826
(318) 437-7157
(318) 437-7158
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
04/19/2018
Last updated
01/07/2019
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