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Organization
BEYOND THE BRICK WALL
Active
Organization
BEYOND THE BRICK WALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NOWLIN GARDNER (PRACTICE MANAGER)
(318) 734-8492
Entity
Organization
Contact information
Practice address
820 JORDAN ST STE 550, SHREVEPORT, LA 71101-4526
(318) 734-9022
Mailing address
820 JORDAN ST STE 550, SHREVEPORT, LA 71101-4526
(318) 734-9022
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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