EDWIN D MIRADOR

SHREVEPORT, LA
NPI1225346836
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  1184)
Enumeration Date2010-09-16
Last Update Date2010-09-16
Business Address
Mr. EDWIN D MIRADOR RAC
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-863-7441
Mailing Address
Mr. EDWIN D MIRADOR RAC
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-863-7441
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