Individual
JACOBIAN RAEON STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
Mailing address
2800 YOUREE DR STE 482, SHREVEPORT, LA 71104-3666
(318) 869-1899
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/04/2018
Last updated
02/03/2022
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