Individual
KHALIL SUMLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 OLIVE ST, SHREVEPORT, LA 71104-2210
(318) 302-6000
Mailing address
3810 EILEEN LN, SHREVEPORT, LA 71109-2022
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
235Z00000X
Speech-Language Pathologist
Primary
9083
LA
Other
Enumeration date
01/21/2020
Last updated
06/07/2022
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