Individual
MR. GARY W TIEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2001 E 70TH STREET, SUITE 106, SHREVEPORT, LA 71105-5393
(318) 798-0518
(318) 798-6697
Mailing address
2001 E 70TH STREET, SUITE 106, SHREVEPORT, LA 71105-5393
(318) 798-0518
(318) 798-6697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2781
LA
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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