Organization
FAMILY PSYCHOLOGY AND COUNSELING
Active
Other names
Bruce McCormick Ph.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE KQ MCCORMICK PH.D. (MEDICAL PSYCHOLOGIST/OWNER)
(318) 865-7500
Entity
Organization
Contact information
Practice address
1513 LINE AVE, SUITE 305, SHREVEPORT, LA 71101-4621
(318) 865-7500
(318) 868-2035
Mailing address
1513 LINE AVE, SUITE 305, SHREVEPORT, LA 71101-4621
(318) 865-7500
(318) 868-2035
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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