Individual
MRS. LESLIE G MULFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
612 PICKETTS MILL DR, SHREVEPORT, LA 71115-3862
(318) 393-9091
Mailing address
612 PICKETTS MILL DR, SHREVEPORT, LA 71115-3862
(318) 393-9091
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12441
LA
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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