Individual
RAENELL ROCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 JEFFERSON HWY, JEFFERSON, LA 70121
(504) 842-3205
Mailing address
1415 JEFFERSON HWY, JEFFERSON, LA 70121
(504) 842-3205
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.021760
LA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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