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1841948981
KYLA BLAZE
SHREVEPORT, LA
NPI
1841948981
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2022-03-17
Last Update Date
2022-03-17
Business Address
KYLA BLAZE
2210 LINE AVE STE 101
SHREVEPORT, LA 71104-2100
Phone number: 318-681-9572
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Mailing Address
KYLA BLAZE
2210 LINE AVE STE 101
SHREVEPORT, LA 71104-2100
Phone number: 318-681-9572
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