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Individual

JESSICA N STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1118 MELANIE DR, SULPHUR, LA 70663-5944
(337) 540-8602
Mailing address
1118 MELANIE DR, SULPHUR, LA 70663-5944
(337) 540-8602

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
171M00000X
Case Manager/Care Coordinator
1744R1102X
Research Study Specialist

Other

Enumeration date
09/09/2021
Last updated
09/23/2024
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