Most Relevant Information
Provider Data
| NPI Number: | 1003280173 |
| Provider Name: | KENXAIVIUS GILES |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/30/2015 |
| Last Updated: | 11/30/2015 |
Provider Practice Location
1100 W 70TH ST APT 401
SHREVEPORT
LA
711063563
Practice Location Phone/Fax
| Phone: | 3185178205 |
| Fax: |
Provider Mailing Location
1100 W 70TH ST APT 401
SHREVEPORT
LA
711063563
Provider Mailing Phone/Fax
| Phone: | 3185178205 |
| Fax: |