Individual
GREGORY CRAYTON STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSS
Contact information
Practice address
527 CROCKETT ST, SHREVEPORT, LA 71101-3601
(318) 517-1139
Mailing address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
OBHPSS1140
LA
Other
Enumeration date
05/29/2024
Last updated
07/25/2024
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