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1679177422
GLEN ELLIS BROWN
RAYVILLE, LA
NPI
1679177422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 4056)
Enumeration Date
2020-11-23
Last Update Date
2020-11-23
Business Address
GLEN ELLIS BROWN
161 COMEAUX RD
RAYVILLE, LA 71269
Phone number: 318-303-5500
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Mailing Address
GLEN ELLIS BROWN
PO BOX 745
RAYVILLE, LA 71269-0745
Phone number: 318-303-5500
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