Individual
PAMELA HARRIS-WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
331 MILAM ST, SHREVEPORT, LA 71101-5353
(318) 213-0904
Mailing address
6002 FAIRFIELD AVE, SHREVEPORT, LA 71106-1916
(318) 205-1906
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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