Individual
MARY PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 MEDOC DR, KENNER, LA 70065-1922
(866) 530-6111
Mailing address
2900 INDIANA AVE, KENNER, LA 70065-4605
(504) 575-3712
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2822
LA
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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