Individual
CHAMPAGNE ALEXANDRIA KEYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
4606 LEE ST, ALEXANDRIA, LA 71302-3235
(318) 441-1105
Mailing address
4606 LEE ST, ALEXANDRIA, LA 71302-3235
(318) 441-1105
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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