Individual
HANNAHJO CHEYENNE UPCHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
(318) 673-9904
Mailing address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
(318) 673-9904
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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