Individual
CHARLES LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6654 GILBERT PL, SHREVEPORT, LA 71106-3425
(318) 865-4360
Mailing address
6654 GILBERT PL, SHREVEPORT, LA 71106-3425
(318) 865-4360
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1971
LA
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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