COREY GLEN WHITE

SHREVEPORT, LA
NPI1891557203
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2024-01-30
Last Update Date2024-01-30
Business Address
COREY GLEN WHITE
404 HEARNE AVE
SHREVEPORT, LA 71103-2022
Phone number: 318-716-1369
Mailing Address
COREY GLEN WHITE
404 HEARNE AVE
SHREVEPORT, LA 71103-2022
Phone number: 318-716-1369
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