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1063609782
ROSS GITHENS
SHREVEPORT, LA
NPI
1063609782
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 1144)
Enumeration Date
2007-09-26
Last Update Date
2018-03-17
Business Address
ROSS GITHENS LAC 1144
520 OLIVE ST
SHREVEPORT, LA 71104-2312
Phone number: 318-459-8922
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Mailing Address
ROSS GITHENS LAC 1144
6129 RIVER RD
SHREVEPORT, LA 71105-4833
Phone number: 318-459-8922
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