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Individual

CASSANDRA DENISE BRAXTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
705 FISHER LN, KENTWOOD, LA 70444
(985) 474-6793
Mailing address
1413 AVENUE L, KENTWOOD, LA 70444-3038
(985) 474-6793

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
008683583
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008430288
LA
Enumeration date
08/05/2021
Last updated
08/05/2021
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