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1386194165
TEDIE NELSON
SHREVEPORT, LA
NPI
1386194165
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-10-05
Last Update Date
2016-10-05
Business Address
-- TEDIE NELSON
4609 N MARKET ST STE. A
SHREVEPORT, LA 71107-2900
Phone number: 318-626-5462
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Mailing Address
-- TEDIE NELSON
4609 N MARKET ST STE. A
SHREVEPORT, LA 71107-2900
Phone number: 318-626-5462
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