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1609306372
GRACE MBENKUM
SHREVEPORT, LA
NPI
1609306372
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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
2017-06-15
Last Update Date
2022-01-19
Business Address
GRACE MBENKUM
5902 BUNCOMBE RD
SHREVEPORT, LA 71129-4004
Phone number: 318-670-8898
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Mailing Address
GRACE MBENKUM
PO BOX 29372
SHREVEPORT, LA 71149-9372
Phone number: 318-670-8898
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