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1003443995
JAVONN WASHINGTON NICHOLAS
TALLULAH, LA
NPI
1003443995
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-03-23
Last Update Date
2020-03-23
Business Address
JAVONN WASHINGTON NICHOLAS
805 N BEECH ST
TALLULAH, LA 71282-3809
Phone number: 318-574-0098
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Mailing Address
JAVONN WASHINGTON NICHOLAS
805 N BEECH ST
TALLULAH, LA 71282-3809
Phone number: 318-574-0098
Copy
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