Most Relevant Information
Provider Data
| NPI Number: | 1003337106 |
| Provider Name: | KENYELL SHANTAE MCLEAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/29/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
8325 KELWOOD AVE.
BATON ROUGE
LA
70806
Practice Location Phone/Fax
| Phone: | 2252455095 |
| Fax: |
Provider Mailing Location
8325 KELWOOD AVE
BATON ROUGE
LA
708064804
Provider Mailing Phone/Fax
| Phone: | 2252455095 |
| Fax: |