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1336681931
MLCOLM DEMERY
SHREVEPORT, LA
NPI
1336681931
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-11-14
Last Update Date
2016-11-14
Business Address
-- MLCOLM DEMERY
3010 NEWPORT ST
SHREVEPORT, LA 71118-2015
Phone number: 318-572-3309
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Mailing Address
-- MLCOLM DEMERY
3010 NEWPORT ST
SHREVEPORT, LA 71118-2015
Phone number:
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