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1629593082
JOHNNY VANCE
SHREVEPORT, LA
NPI
1629593082
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 2203782947)
Enumeration Date
2017-08-07
Last Update Date
2017-08-07
Business Address
JOHNNY VANCE
1500 N MARKET ST
SHREVEPORT, LA 71107-6537
Phone number: 318-626-5597
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Mailing Address
JOHNNY VANCE
4302 N MARKET ST
SHREVEPORT, LA 71107-2966
Phone number:
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