Bush, Gladys T
Bush, Gladys T is an sole proprietor health care provider with primary practice located at 9501 Chase Way , Shreveport LA 71118-4619. She recently has only one registered license in Other Service Providers / Prevention Professional, which is considered as her primary health care specialty. Bush, Gladys T can be contacted via phone (318) 773-0657.Contact Information
Primary practice address
9501 Chase Way
Shreveport LA 71118-4619
Phone: (318) 773-0657
Fax: (318) 688-1559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prevention Professional | 405300000X | 60312804 | New York |
Profile Details
| NPI number | 1891326690 |
|---|---|
| LBN Legal business name | Bush, Gladys T |
| Credentials | HEALTH COACH CCMA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2020 |
| Last updated | Jan 30th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891326690 | NPPES |
| Louisiana | Other | K5C6Y6M8 | CCMA |
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