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1528514015
JESSICA LOGAN
SHREVEPORT, LA
NPI
1528514015
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
251S00000X
Enumeration Date
2016-08-25
Last Update Date
2018-05-21
Business Address
JESSICA LOGAN
1513 LINE AVE STE 315
SHREVEPORT, LA 71101
Phone number: 318-221-2828
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Mailing Address
JESSICA LOGAN
1513 LINE AVE STE 315
SHREVEPORT, LA 71101-4621
Phone number: 318-221-2828
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