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1538511449
SHANEDRA FULLER
SHREVEPORT, LA
NPI
1538511449
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-07-05
Last Update Date
2016-07-05
Business Address
-- SHANEDRA FULLER
3126 BERT KOUN LOOP
SHREVEPORT, LA 71118-2903
Phone number: 318-469-2183
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Mailing Address
-- SHANEDRA FULLER
3126 BERT KOUN LOOP
SHREVEPORT, LA 71118-2903
Phone number:
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