ASHTON PENNYWELL

SHREVEPORT, LA
NPI1467989988
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2017-05-15
Last Update Date2022-07-21
Business Address
ASHTON PENNYWELL
1513 LINE AVE STE 225
SHREVEPORT, LA 71101
Phone number: 318-754-3890
Mailing Address
ASHTON PENNYWELL
1513 LINE AVE STE 225
SHREVEPORT, LA 71101-4621
Phone number: 318-754-3890
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