Most Relevant Information
Provider Data
| NPI Number: | 1003573437 |
| Provider Name: | LAQUETTA JARVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/19/2021 |
| Last Updated: | 11/19/2021 |
Provider Practice Location
1056 E WORTHY ST STE B
GONZALES
LA
707374369
Practice Location Phone/Fax
| Phone: | 2256215770 |
| Fax: | 2256443208 |
Provider Mailing Location
PO BOX 66558
BATON ROUGE
LA
708966558
Provider Mailing Phone/Fax
| Phone: | 2256215770 |
| Fax: | 2256443208 |