Individual
MR. JEREMY A LUALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSMFT, PLPC
Contact information
Practice address
622 RIVERSIDE DR, MONROE, LA 71201-6211
(318) 398-1760
Mailing address
622 RIVERSIDE DR, MONROE, LA 71201-6211
(318) 398-1760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/31/2010
Last updated
12/21/2015
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