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1356161848
JUSTICE MODISETTE
SHREVEPORT, LA
NPI
1356161848
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: LA R-19185)
Enumeration Date
2024-10-10
Last Update Date
2024-10-10
Business Address
JUSTICE MODISETTE
2522 E 70TH ST
SHREVEPORT, LA 71105-4002
Phone number: 318-795-3388
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Mailing Address
JUSTICE MODISETTE
2522 E 70TH ST
SHREVEPORT, LA 71105-4002
Phone number: 318-795-3388
Copy
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