Individual
DAMEON DECAVEN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 E KINGS HWY STE 101, SHREVEPORT, LA 71104
(318) 606-5335
(318) 606-5671
Mailing address
2810 FREDDIE ST, SHREVEPORT, LA 71107-4216
(318) 606-5335
(318) 606-5671
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
821613802
MENTAL HEALTH
LA
Enumeration date
10/28/2017
Last updated
06/15/2018
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