Individual
MRS. KASEY JO CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
2522 E 70TH ST, SHREVEPORT, LA 71105-4002
(318) 795-3388
Mailing address
613 SIMPSON ST, BENTON, LA 71006-8314
(618) 599-2295
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
300693
LA
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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