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1831795764
EBONY NICOLE KENNEDY
LAKE CHARLES, LA
NPI
1831795764
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-12-07
Last Update Date
2020-12-07
Business Address
EBONY NICOLE KENNEDY Mastered Level
1639 RYAN ST
LAKE CHARLES, LA 70601-5948
Phone number: 985-360-6199
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Mailing Address
EBONY NICOLE KENNEDY Mastered Level
1639 RYAN ST
LAKE CHARLES, LA 70601-5948
Phone number: 985-360-6199
Copy
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