Provider Demographics
NPI:1013573468
Name:COJOE, RAEVEN TROIE
Entity Type:Individual
Prefix:
First Name:RAEVEN
Middle Name:TROIE
Last Name:COJOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3455
Mailing Address - Country:US
Mailing Address - Phone:504-606-0813
Mailing Address - Fax:
Practice Address - Street 1:10 TULIP LN
Practice Address - Street 2:
Practice Address - City:SAINT ROSE
Practice Address - State:LA
Practice Address - Zip Code:70087-3455
Practice Address - Country:US
Practice Address - Phone:504-606-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator