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1043873631
JODY LOWERY WALDO
SHREVEPORT, LA
NPI
1043873631
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 4237)
Enumeration Date
2019-04-18
Last Update Date
2019-04-18
Business Address
JODY LOWERY WALDO CIT
2000 FAIRFIELD AVE
SHREVEPORT, LA 71104-2099
Phone number: 318-222-8511
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Mailing Address
JODY LOWERY WALDO CIT
2000 FAIRFIELD AVE
SHREVEPORT, LA 71104-2099
Phone number: 318-222-8511
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