Healthcare Provider Details

I. General information

NPI: 1427428739
Provider Name (Legal Business Name): JOKEIRRA SNEED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4306 S GRAND ST
MONROE LA
71202-6322
US

IV. Provider business mailing address

4306 S GRAND ST
MONROE LA
71202-6322
US

V. Phone/Fax

Practice location:
  • Phone: 318-413-5723
  • Fax:
Mailing address:
  • Phone: 318-413-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: