Individual
DEOINICEA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 HILRY HUCKABY DR, SHREVEPORT, LA 71107-5707
(318) 670-9719
Mailing address
4646 HILRY HUCKABY DR, SHREVEPORT, LA 71107-5707
(318) 670-9719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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