Individual
FREDRICK MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 N THOMAS DR, SUITE A, SHREVEPORT, LA 71107
(318) 424-8345
Mailing address
6051 ROMA DR APT 519, SHREVEPORT, LA 71105-4670
(601) 410-5505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
08/17/2018
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