Individual
JUTORREAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
856 TEXAS AVE, SHREVEPORT, LA 71101-3400
(318) 429-6977
Mailing address
856 TEXAS AVE, SHREVEPORT, LA 71101-3400
(318) 429-6977
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
14378
LA
Other
Enumeration date
06/26/2017
Last updated
09/27/2018
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