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1891326690
GLADYS T BUSH
SHREVEPORT, LA
NPI
1891326690
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
405300000X Prevention Professional
(Licence: NY 60312804)
Enumeration Date
2020-01-30
Last Update Date
2020-01-30
Business Address
GLADYS T BUSH Health Coach CCMA
9501 CHASE WAY
SHREVEPORT, LA 71118-4619
Phone number: 318-773-0657
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Mailing Address
GLADYS T BUSH Health Coach CCMA
PO BOX 19284
SHREVEPORT, LA 71149-0284
Phone number: 318-773-0657
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