Individual
MISS KARMELLA DESHONA MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
406 BOYKIN ST, HOUMA, LA 70360-4010
(985) 580-2165
(985) 223-4424
Mailing address
406 BOYKIN ST, HOUMA, LA 70360-4010
(985) 580-2165
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PCA 9568
LA
Other
Enumeration date
03/04/2007
Last updated
07/08/2007
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