Individual
JANIKLA JANTAVEIA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
651 GARR RD, RUSTON, LA 71270-1145
(318) 278-0264
Mailing address
3776 YOUREE DR, SHREVEPORT, LA 71105-2132
(318) 670-3159
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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