Individual
MR. MARK S. DEBORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
212 CYPRESS ST, WEST MONROE, LA 71291-3120
(318) 381-9070
(318) 322-1477
Mailing address
212 CYPRESS ST, WEST MONROE, LA 71291-3120
(318) 381-9070
(318) 322-1477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1947
LA
Other
Enumeration date
10/14/2005
Last updated
03/06/2012
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