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1992210447
QUOVASE KELLY
LAKE CHARLES, LA
NPI
1992210447
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-12-06
Last Update Date
2018-12-13
Business Address
Mrs. QUOVASE KELLY
1409 KIRKMAN ST
LAKE CHARLES, LA 70601-5344
Phone number: 337-419-3586
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Mailing Address
Mrs. QUOVASE KELLY
1409 KIRKMAN ST
LAKE CHARLES, LA 70601-5344
Phone number: 337-419-3586
Copy
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