Individual
MR. BRIAN O WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1314C
AR
1041C0700X
Clinical Social Worker
Primary
10698
LA
Other
Enumeration date
10/12/2007
Last updated
10/10/2023
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