Individual
MRS. MARION MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9045 KINGSTON RD, APT. # 1001, SHREVEPORT, LA 71118-3466
(318) 402-9957
(318) 716-1234
Mailing address
9045 KINGSTON RD, APT. # 1001, SHREVEPORT, LA 71118-3466
(318) 402-9957
(318) 716-1234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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