Individual
JAMIE DEMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2053 GAUSE BLVD E, SLIDELL, LA 70461-5449
(985) 649-1001
(985) 646-1005
Mailing address
2053 GAUSE BLVD E, SLIDELL, LA 70461-5449
(985) 649-1001
(985) 646-1005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
007748640
LA
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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