CONSTANCE COLETTLE ELLIS

SHREVEPORT, LA
NPI1104337856
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2017-10-21
Last Update Date2018-05-17
Business Address
CONSTANCE COLETTLE ELLIS
9245 WALLACE LAKE RD STE A
SHREVEPORT, LA 71106
Phone number: 318-221-2828
Mailing Address
CONSTANCE COLETTLE ELLIS
PO BOX 349
STONEWALL, LA 71078-0349
Phone number:
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