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Individual

RODERICK JERMAINE LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2915 MACKEY LANE, SHREVEPORT, LA 71118-0000
(318) 518-9002
Mailing address
8533 ROITAN DR, SHREVEPORT, LA 71106-5813
(318) 518-9002

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/27/2017
Last updated
06/27/2017
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