Individual
MR. MATTHEW JOSEPH TISBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. DIV.
Contact information
Practice address
2437 ROY RD, SHREVEPORT, LA 71107
(318) 424-9584
(318) 424-6121
Mailing address
2437 ROY RD, SHREVEPORT, LA 71107
(318) 424-9584
(318) 424-6121
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
09/19/2006
Last updated
07/08/2007
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