Individual
MS. MEDA ANN KILLGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
124 KILGORE RD, RUSTON, RUSTON, LA 71270-7084
(318) 251-1418
(318) 255-1189
Mailing address
200 JEFFERSON OAKS DR, RUSTON, RUSTON, LA 71270-7083
(318) 255-5145
(318) 255-1189
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4345
LA
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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