Individual
CRYSTAL HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1533 MARSHALL ST, SHREVEPORT, LA 71101-3941
(318) 626-5597
Mailing address
7000 RED FOX TRL APT 266, SHREVEPORT, LA 71129-3547
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
LA
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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