Individual
JOVONDA FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6685 SULLIVAN RD STE B, GREENWELL SPRINGS, LA 70739-3112
(225) 261-7143
Mailing address
PO BOX 1328, SPRINGFIELD, LA 70462-1328
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00693075
—
LA
Enumeration date
07/16/2019
Last updated
07/16/2019
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