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Individual

MR. ROBERT E OLIVER III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PLPC

Contact information

Practice address
2620 CENTENARY BLVD, SHREVEPORT, LA 71104
(318) 681-9935
Mailing address
2620 CENTENARY BLVD, SHREVEPORT, LA 71104-3356
(318) 681-9935

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC9714
LA
171M00000X
Case Manager/Care Coordinator
007016682
LA

Other

Enumeration date
11/05/2015
Last updated
11/21/2023
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