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1770278970
IBTISAM N ISSA
SHREVEPORT, LA
NPI
1770278970
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Other Name
SAM ISSA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: LA L-691)
Enumeration Date
2023-04-05
Last Update Date
2023-04-05
Business Address
IBTISAM N ISSA
925 OLIVE ST
SHREVEPORT, LA 71104-2103
Phone number: 318-300-3560
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Mailing Address
IBTISAM N ISSA
925 OLIVE ST
SHREVEPORT, LA 71104-2103
Phone number: 318-300-3560
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