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1568959955
JEREMY WILSON THEODORE
HOUMA, LA
NPI
1568959955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-04-20
Last Update Date
2018-04-20
Business Address
JEREMY WILSON THEODORE
1340 W TUNNEL BLVD STE 230
HOUMA, LA 70360-2811
Phone number: 504-314-1737
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Mailing Address
JEREMY WILSON THEODORE
1340 W TUNNEL BLVD STE 230
HOUMA, LA 70360-2811
Phone number: 504-314-1737
Copy
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