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1902956840
CLARENCE GEORGE GARDNER
SHREVEPORT, LA
NPI
1902956840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: LA 296)
Enumeration Date
2007-01-11
Last Update Date
2007-07-08
Business Address
-- CLARENCE GEORGE GARDNER Th.M., LMFT
9524 CASTLEBROOK DR
SHREVEPORT, LA 71129-4810
Phone number: 318-688-6208
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Mailing Address
-- CLARENCE GEORGE GARDNER Th.M., LMFT
9524 CASTLEBROOK DR
SHREVEPORT, LA 71129-4810
Phone number: 318-688-6208
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