Individual
ANGELA MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 PETE MARTIN RD, ANACOCO, LA 71403
(903) 399-6679
Mailing address
302 PETE MARTIN RD, ANACOCO, LA 71403-3346
(903) 399-6679
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2017
Last updated
07/06/2018
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