RAVEN BERRY

SHREVEPORT, LA
NPI1770942039
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101Y00000X Counselor
101YM0800X Counselor, Mental Health
Enumeration Date2016-02-15
Last Update Date2018-06-14
Business Address
RAVEN BERRY
4609 N MARKET ST
SHREVEPORT, LA 71107
Phone number: 318-626-5462
Mailing Address
RAVEN BERRY
4019 GREENWOOD RD
SHREVEPORT, LA 71109-6422
Phone number: 318-626-5462