Individual
KIOME BRADSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 BELLE CHASSE HWY, GRETNA, LA 70053
(504) 367-6630
Mailing address
4900 LANCELOT DR, NEW ORLEANS, LA 70127-3248
(504) 875-9910
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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