Individual
MRS. OLIVIA COMMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
651 RUE SAINT MICHAEL, GRETNA, LA 70056-8224
(504) 400-2066
Mailing address
651 RUE SAINT MICHAEL, GRETNA, LA 70056-8224
(504) 400-2066
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/17/2019
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