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1265261069
AUSTIN MICHAEL THERIOT
SHREVEPORT, LA
NPI
1265261069
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-07-30
Last Update Date
2024-09-09
Business Address
AUSTIN MICHAEL THERIOT RPSS
527 CROCKETT ST
SHREVEPORT, LA 71101-3601
Phone number: 318-222-8511
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Mailing Address
AUSTIN MICHAEL THERIOT RPSS
2000 FAIRFIELD AVE
SHREVEPORT, LA 71104-2002
Phone number: 318-222-8511
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