KRYSTAL PEA

SHREVEPORT, LA
NPI1790158400
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: LA  5809)
Additional Taxonomies101YM0800X Counselor, Mental Health
171M00000X Case Manager/Care Coordinator
Enumeration Date2015-11-03
Last Update Date2019-05-13
Business Address
KRYSTAL PEA
2219 CLAIBORNE AVE
SHREVEPORT, LA 71103-4301
Phone number: 318-779-0434
Mailing Address
KRYSTAL PEA
4023 ESPLANADE AVE
SHREVEPORT, LA 71109-5036
Phone number: 318-572-7418