Individual
JESSICA MAUTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 YOUREE DR, SUITE 110, SHREVEPORT, LA 71104
(318) 742-3408
Mailing address
2525 YOUREE DR, SUITE 110, SHREVEPORT, LA 71104-3671
(318) 742-3408
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11820
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2016
Last updated
08/10/2018
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