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1134586886
JESSIE PUCKETT
SHREVEPORT, LA
NPI
1134586886
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-01-26
Last Update Date
2016-01-26
Business Address
-- JESSIE PUCKETT
2525 YOUREE DR STE 110
SHREVEPORT, LA 71104-3600
Phone number: 318-675-0804
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Mailing Address
-- JESSIE PUCKETT
2525 YOUREE DR STE 110
SHREVEPORT, LA 71104-3600
Phone number:
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