Individual
DEMETRIUS GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2352 FERNBROOK DR, SHREVEPORT, LA 71118-5215
(318) 393-5543
Mailing address
2352 FERNBROOK DR, SHREVEPORT, LA 71118-5215
(318) 393-5543
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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