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1801669551
KELVIN KERON WHITE
SHREVEPORT, LA
NPI
1801669551
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2023-11-03
Last Update Date
2024-02-20
Business Address
Mr. KELVIN KERON WHITE
1842 IRVING PL
SHREVEPORT, LA 71101-4608
Phone number: 318-219-3500
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Mailing Address
Mr. KELVIN KERON WHITE
9990 FREEDOMS WAY
KEITHVILLE, LA 71047-9222
Phone number: 318-518-0893
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