Individual
JUHNELL LIZETTE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7607 FERN AVE STE 903, SHREVEPORT, LA 71105-5745
(318) 524-9954
Mailing address
7607 FERN AVE STE 903, SHREVEPORT, LA 71105-5745
(318) 524-9954
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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