Fontenot, Mary Necoloa

Fontenot, Mary Necoloa is an individual health care provider with primary practice located at 1324 Rosetta St , Lake Charles LA 70607-1932. She recently has only one registered license in Other Service Providers / Vehicle Modifications, which is considered as her primary health care specialty. Fontenot, Mary Necoloa can be contacted via phone (337) 912-8617.

Contact Information

Primary practice address
1324 Rosetta St Lake Charles LA 70607-1932
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Vehicle Modifications 171WV0202X 008907424 Louisiana

Profile Details

NPI number 1346744042
LBN Legal business name Fontenot, Mary Necoloa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2018
Last updated Mar 19th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346744042 NPPES
Louisiana MEDICAID 882717925

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