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1518582105
MADDISON NICOLE BENGE
SHREVEPORT, LA
NPI
1518582105
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-06-10
Last Update Date
2021-05-20
Business Address
MADDISON NICOLE BENGE
1434 HAWN AVE
SHREVEPORT, LA 71107-6508
Phone number: 318-675-0224
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Mailing Address
MADDISON NICOLE BENGE
6304 WILLOWOOD PL
SHREVEPORT, LA 71107-8113
Phone number: 318-294-4456
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