Individual
JAWAN KEETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 YOUREE DR STE 110, SHREVEPORT, LA 71104
(318) 675-0804
Mailing address
6709 N PARK CIR, SHREVEPORT, LA 71107-9128
(318) 564-2429
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2016
Last updated
08/07/2018
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