NPI 1891326690

Gladys T Bush, HEALTHCOACHCCMA

Practitioner Prevention Professional Shreveport, LA

Practice location

Address: 9501 Chase Way, Shreveport, LA 71118-4619
Phone: (318) 773-0657
Fax: (318) 688-1559
Mailing address: PO Box 19284, Shreveport, LA 71149-0284

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 60312804 (NY)

Other Prevention Professional providers in Louisiana →

Registry record

NPI: 1891326690
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jan 2020
Record last updated: 30 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.