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1548774797
JACQUILLA STEPHENS MOTON
SHREVEPORT, LA
NPI
1548774797
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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
2017-11-27
Last Update Date
2018-07-31
Business Address
JACQUILLA STEPHENS MOTON
1500 N MARKET ST STE C104
SHREVEPORT, LA 71107
Phone number: 318-626-5597
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Mailing Address
JACQUILLA STEPHENS MOTON
1500 N MARKET ST STE C104
SHREVEPORT, LA 71107-6545
Phone number: 318-626-5597
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