Individual
DEANDREA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
Mailing address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
009322801
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/23/2016
Last updated
07/11/2019
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