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1093239352
DERRICK LAMAR ADDISON
SHREVEPORT, LA
NPI
1093239352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-07-28
Last Update Date
2017-07-28
Business Address
DERRICK LAMAR ADDISON
9467 MILBANK DR
SHREVEPORT, LA 71115-3868
Phone number: 318-655-6318
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Mailing Address
DERRICK LAMAR ADDISON
1717 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number:
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