JUAN MANUEL GOMEZ

SHREVEPORT, LA
NPI1962506550
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2006-09-12
Last Update Date2007-07-08
Business Address
-- JUAN MANUEL GOMEZ
510 EAST STONER AVE
SHREVEPORT, LA 71101-4295
Phone number: 318-221-8411
Mailing Address
-- JUAN MANUEL GOMEZ
102 LAKEWOOD PT
BOSSIER CITY, LA 71111-2000
Phone number: 318-742-3077
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