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Individual

ALYSE WELLS HOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 222-5704
(315) 226-5797
Mailing address
362 LEO AVE, SHREVEPORT, LA 71105-2916
(318) 229-2681

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
AR

Other

Enumeration date
02/12/2013
Last updated
02/11/2022
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