Individual
SHASTA DENISE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2704 CARLISLE DR S, GRETNA, LA 70056-7705
(504) 912-7142
Mailing address
2704 CARLISLE DR S, GRETNA, LA 70056-7705
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
LA
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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