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1750869285
LARRY COLENZO WILSON
SHREVEPORT, LA
NPI
1750869285
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-08-06
Last Update Date
2018-08-06
Business Address
Mr. LARRY COLENZO WILSON
6224 N INWOOD RD
SHREVEPORT, LA 71119-7213
Phone number: 318-453-0447
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Mailing Address
Mr. LARRY COLENZO WILSON
6224 N INWOOD RD
SHREVEPORT, LA 71119-7213
Phone number: 318-453-0447
Copy
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