Raw Ingenuity Llc | |
752 Tyson Dr Pineville LA 71360-5698 | |
(318) 401-1945 | |
Not Available |
Full Name | Raw Ingenuity Llc |
---|---|
Speciality | Counselor - Professional |
Location | 752 Tyson Dr, Pineville, Louisiana |
Authorized Official Name and Position | Quaneice Perry (OWNER) |
Authorized Official Contact | 3184011945 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Raw Ingenuity Llc Po Box 3472 Pineville LA 71361-3472 Ph: () - | Raw Ingenuity Llc 752 Tyson Dr Pineville LA 71360-5698 Ph: (318) 401-1945 |
NPI Number | 1154038602 |
---|---|
Provider Enumeration Date | 11/03/2022 |
Last Update Date | 11/03/2022 |
Certification Date | 11/03/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154038602 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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