Individual
BESSIE LARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1513 LINE AV, 222, SHREVEPORT, LA 71101
(318) 208-8908
(318) 208-8935
Mailing address
1513 LINE AVE, 222, SHREVEPORT, LA 71101
(318) 208-8908
(318) 208-8935
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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