Individual
OCTAVIA PAULETTE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N BOGLE RD APT 16, LOGANSPORT, LA 71049-2613
(936) 427-0374
Mailing address
501 N BOGLE RD APT 16, LOGANSPORT, LA 71049-2613
(936) 427-0374
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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