Individual
MR. RUSSELL GLENN SEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
10008 FERRY CREEK DR, SHREVEPORT, LA 71106-8406
(318) 773-0103
(318) 676-5086
Mailing address
10008 FERRY CREEK DR, SHREVEPORT, LA 71106-8406
(318) 773-0103
(318) 676-5086
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2654
LA
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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