Individual
JENESSY RALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 N 18TH ST STE 217, MONROE, LA 71201-4419
(318) 600-6838
Mailing address
525 BIRCHWOOD DR, MONROE, LA 71203-2207
(318) 503-9347
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
NONE
—
Enumeration date
09/12/2017
Last updated
07/21/2022
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