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Individual

GLORY DEATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
430 DIXIE PLZ, NATCHITOCHES, LA 71457-5881
(318) 357-9008
Mailing address
3625 YOUREE DR, SHREVEPORT, LA 71105-2121

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
10/10/2018
Last updated
12/05/2018
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