Individual
JASHEIKA DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
2419 COBURN LN, SHREVEPORT, LA 71107-6010
(318) 762-1225
Mailing address
2419 COBURN LN, SHREVEPORT, LA 71107-6010
(318) 762-1225
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811240931
—
LA
Enumeration date
11/17/2016
Last updated
04/23/2019
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