Individual
EVANGELA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 E 70TH ST # 259, SHREVEPORT, LA 71105-5115
(318) 734-9051
Mailing address
1651 E 70TH ST # 259, SHREVEPORT, LA 71105-5115
(318) 734-9051
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/06/2016
Last updated
11/06/2016
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