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1225493109
BRODERICK HUNTER
SHREVEPORT, LA
NPI
1225493109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2015-12-21
Last Update Date
2018-08-21
Business Address
BRODERICK HUNTER
254 OLYMPIA DR
SHREVEPORT, LA 71106
Phone number: 318-918-9363
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Mailing Address
BRODERICK HUNTER
254 OLYMPIA DR
SHREVEPORT, LA 71106-7557
Phone number:
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