Individual
JACOBI CORRELL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHS
Contact information
Practice address
7007 BOBTAIL DR, SHREVEPORT, LA 71129-3417
(318) 364-7766
Mailing address
7007 BOBTAIL DR, SHREVEPORT, LA 71129-3417
(318) 364-7766
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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