Organization
REHAB SERVICES
Active
Organization
REHAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE HESTER (MENTAL HEALTH SPECIALIST)
(318) 202-3706
Entity
Organization
Contact information
Practice address
2525 YOUREE DR STE 110, SHREVEPORT, LA 71104-3600
(318) 742-3408
Mailing address
2525 YOUREE DR SUITE 110, SHREVEPORT, LA 71104
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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