Organization
MICAH SPEAKS KID CAMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BALLARD (PRESIDENT)
(225) 348-6807
Entity
Organization
Contact information
Practice address
201 JEFFREY DR APT 206G, LAFAYETTE, LA 70503-4566
(225) 348-6807
Mailing address
201 JEFFREY DR APT 206G, LAFAYETTE, LA 70503-4566
(225) 348-6807
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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