Individual
JACQUELINE RENEE BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1916 VIVIAN ST, SHREVEPORT, LA 71108-2234
(318) 946-0146
Mailing address
1916 VIVIAN ST, SHREVEPORT, LA 71108-2234
(318) 946-0146
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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