Individual
TERRY MCCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRSS/PSS/WRAP
Contact information
Practice address
2818 JODY LN, SHREVEPORT, LA 71118-2536
(318) 795-9019
Mailing address
2818 JODY LN, SHREVEPORT, LA 71118-2536
(318) 795-9019
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
046
LA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
09/27/2018
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