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1780197996
EDWIN JEFFERSON
SHREVEPORT, LA
NPI
1780197996
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-11-09
Last Update Date
2017-11-09
Business Address
EDWIN JEFFERSON
1717 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number: 318-226-9944
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Mailing Address
EDWIN JEFFERSON
6416 JOY DR
SHREVEPORT, LA 71119-5110
Phone number: 318-834-9629
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