Individual
JALEN OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2219 CLAIBORNE AVE, SHREVEPORT, LA 71103-4301
(318) 779-0434
(318) 210-0000
Mailing address
2219 CLAIBORNE AVE, SHREVEPORT, LA 71103-4301
(318) 779-0434
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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