Individual
HEATHER WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3560 LILLIAN ST, SHREVEPORT, LA 71109-2529
(318) 655-4402
Mailing address
3560 LILLIAN ST, SHREVEPORT, LA 71109-2529
(318) 655-4402
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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