Individual
MATTHEW CRAIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1024 QUAIL CREEK RD APT 204, SHREVEPORT, LA 71105
(318) 703-7740
Mailing address
1024 QUAIL CREEK RD APT 204, SHREVEPORT, LA 71105-2380
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171W00000X
Contractor
—
LA
171W00000X
Contractor
—
—
Other
Enumeration date
09/25/2015
Last updated
05/21/2018
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