Individual
TIMOTHY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
847 NEW LONDON ST, SHREVEPORT, LA 71118-3524
(318) 688-9292
Mailing address
847 NEW LONDON ST, SHREVEPORT, LA 71118-3524
(318) 688-9292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3473
LA
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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