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Individual

JEWELL DUKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8326 KELWOOD AVE, BATON ROUGE, LA 70806-4803
(985) 316-8030
Mailing address
8326 KELWOOD AVE, BATON ROUGE, LA 70806-4803
(985) 316-8030

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002554477
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002554477
LA
Enumeration date
01/13/2020
Last updated
01/13/2020
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