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Individual

MS. CAROLYN LACOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3510 LINWOOD AVE, SHREVEPORT, LA 71103-4512
(318) 636-4194
(318) 636-4196
Mailing address
1820 BENTON RD, BOSSIER CITY, LA 71111-3517
(318) 213-1080
(318) 584-7185

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1885029
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1885029
LA
Enumeration date
08/09/2016
Last updated
08/09/2016
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