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1205200557
TERRIS MIKE
SHREVEPORT, LA
NPI
1205200557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
104100000X Social Worker
Enumeration Date
2015-11-24
Last Update Date
2019-05-29
Business Address
TERRIS MIKE
2219 CLAIBORNE AVE
SHREVEPORT, LA 71103-4301
Phone number: 318-779-0434
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Mailing Address
TERRIS MIKE
2924 KNIGHT ST #434
SHREVEPORT, LA 71105-2415
Phone number: 318-631-1122
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