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1417450420
SHANNON LOUELLA BULLOCK
NEW ORLEANS, LA
NPI
1417450420
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2018-03-15
Last Update Date
2018-06-16
Business Address
SHANNON LOUELLA BULLOCK
10711 VIENNA ST
NEW ORLEANS, LA 70127
Phone number: 504-813-4616
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Mailing Address
SHANNON LOUELLA BULLOCK
10711 VIENNA ST
NEW ORLEANS, LA 70127-3117
Phone number: 504-813-4616
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