Provider Demographics
NPI:1568751691
Name:LOVE, SYMETHA TYESE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:SYMETHA
Middle Name:TYESE
Last Name:LOVE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 BISHOP DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2528
Mailing Address - Country:US
Mailing Address - Phone:504-436-2841
Mailing Address - Fax:
Practice Address - Street 1:164 BISHOP DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:LA
Practice Address - Zip Code:70094
Practice Address - Country:US
Practice Address - Phone:504-436-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator