Individual
MR. CLARENCE MCSHAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 603-4696
Mailing address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760852511
—
LA
Enumeration date
07/11/2017
Last updated
03/17/2018
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