Individual
GWENZETTA JANISE BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 COYLE ST, SPRINGHILL, LA 71075-3014
(318) 205-2064
Mailing address
1002 COYLE ST, SPRINGHILL, LA 71075-3014
(318) 205-2064
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
09/30/2015
Last updated
06/05/2019
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