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1891410544
GRACIE LANE MAXWELL
BOSSIER CITY, LA
NPI
1891410544
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: LA 9113)
Enumeration Date
2022-10-05
Last Update Date
2022-10-05
Business Address
GRACIE LANE MAXWELL
4350 VIKING LOOP STE 1
BOSSIER CITY, LA 71111-7421
Phone number: 318-746-1199
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Mailing Address
GRACIE LANE MAXWELL
2940 LE OAKS DR APT 1513
BOSSIER CITY, LA 71111-7840
Phone number:
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