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1053853754
KESHA IVY
BOSSIER CITY, LA
NPI
1053853754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2016-11-11
Last Update Date
2018-05-21
Business Address
KESHA IVY
2285 BENTON RD SUITE D-103
BOSSIER CITY, LA 71111
Phone number: 318-584-7197
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Mailing Address
KESHA IVY
2285 BENTON RD SUITE D-103
BOSSIER CITY, LA 71111-7933
Phone number: 318-584-7197
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