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1104311257
IVORY HEADSPETH MITCHELL
HAMMOND, LA
NPI
1104311257
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Former Name
IVORY HEADSPETH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2018-06-29
Last Update Date
2018-06-29
Business Address
IVORY HEADSPETH MITCHELL LPN
906 C M FAGAN DR BLDG A
HAMMOND, LA 70403-6056
Phone number: 985-956-7370
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Mailing Address
IVORY HEADSPETH MITCHELL LPN
906 C M FAGAN DR BLDG A
HAMMOND, LA 70403-6056
Phone number: 985-956-7370
Copy
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