Provider Demographics
NPI:1619637790
Name:CALVIN, JULIANNE HONORE
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:HONORE
Last Name:CALVIN
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 1:9408 ROYALTON DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3613
Mailing Address - Country:US
Mailing Address - Phone:318-210-9265
Mailing Address - Fax:
Practice Address - Street 1:6009 FINANCIAL PLZ STE 102
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2615
Practice Address - Country:US
Practice Address - Phone:318-828-1455
Practice Address - Fax:318-828-1626
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator