MIRANDA HENLEY THEODOS

JONESBORO, LA
NPI1326712449
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2021-08-03
Last Update Date2021-08-16
Business Address
MIRANDA HENLEY THEODOS
525 ALEXANDER ST
JONESBORO, LA 71251-2001
Phone number: 318-259-4676
Mailing Address
MIRANDA HENLEY THEODOS
1408 TECH FARM RD APT D15
RUSTON, LA 71270-5484
Phone number: