Individual
ERICA KELLY SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
650 S 2ND ST, PONCHATOULA, LA 70454-2804
(985) 974-6394
Mailing address
650 S 2ND ST, PONCHATOULA, LA 70454-2804
(985) 974-6394
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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