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1659889996
NEVADA MARIE GAINES
BOSSIER CITY, LA
NPI
1659889996
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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
2018-01-22
Last Update Date
2018-05-29
Business Address
NEVADA MARIE GAINES
4000 AIRLINE DR
BOSSIER CITY, LA 71111
Phone number: 318-588-5012
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Mailing Address
NEVADA MARIE GAINES
4000 AIRLINE DR
BOSSIER CITY, LA 71111-2042
Phone number: 318-588-5012
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