Individual
DIAMOND MARIE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9403 MANSFIELD RD., SHREVEPORT, LA 71118
(318) 861-8938
Mailing address
3409 CLAYTON CT., SHREVEPORT, LA 71118
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/13/2019
Last updated
02/13/2019
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