Individual
JEBRIA BUNTYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2626 CHARLES DR, CHALMETTE, LA 70043-3779
(504) 278-4007
Mailing address
2626 CHARLES DR, CHALMETTE, LA 70043-3779
(504) 278-4007
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/09/2015
Last updated
09/27/2016
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