Individual
JORDAN ASHLEY RIDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2110 OAK PARK BLVD, LAKE CHARLES, LA 70601-7864
(337) 475-0324
Mailing address
2007 3RD AVE, LAKE CHARLES, LA 70601-6459
(337) 564-8715
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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