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Individual

KASSANDRA BARRERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2745 COTTAGE STREET, 1038, JACKSON, LA 70748
(225) 245-2257
(225) 351-9033
Mailing address
2745 COTTAGE STREET, 1038, JACKSON, LA 70748
(225) 245-2257
(225) 351-9033

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
861509583
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
86-1509583
LA
Enumeration date
02/02/2021
Last updated
02/02/2021
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