Individual
MLCOLM DEMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3010 NEWPORT ST, SHREVEPORT, LA 71118-2015
(318) 572-3309
Mailing address
3010 NEWPORT ST, SHREVEPORT, LA 71118-2015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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