Individual
RAVEN S RYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2924 KNIGHT ST, SHREVEPORT, LA 71105-2415
(318) 840-5260
Mailing address
2924 KNIGHT ST, SHREVEPORT, LA 71105-2415
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13137
LA
Other
Enumeration date
10/03/2017
Last updated
10/16/2024
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