Individual
DEMETRICE E TOLLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8070A CROWDER BLVD, NEW ORLEANS, LA 70127-1063
(504) 410-2316
Mailing address
8070A CROWDER BLVD, NEW ORLEANS, LA 70127-1063
(504) 410-2316
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
LA
Enumeration date
02/12/2019
Last updated
02/12/2019
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