DERRICK LAMAR ADDISON

SHREVEPORT, LA
NPI1093239352
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2017-07-28
Last Update Date2017-07-28
Business Address
DERRICK LAMAR ADDISON
9467 MILBANK DR
SHREVEPORT, LA 71115-3868
Phone number: 318-655-6318
Mailing Address
DERRICK LAMAR ADDISON
1717 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number:
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