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Wayne Domalaon
Mental Health Counselor in Shreveport, Louisiana
NPI 1275905325

Wayne Domalaon is a Mental Health Counselor based in Shreveport, LA and is specialized in Mental Health. Wayne Domalaon practices in Shreveport, LA. The NPI Number for Wayne Domalaon is 1275905325 and holds a License No. (Louisiana).

The current practice location address for Wayne Domalaon is 9000 W Wilderness Way Apt 32, Shreveport, LA and can be reached out via phone at 318-675-9101.

Location: 9000 W Wilderness Way Apt 32, Shreveport, LA, 71106-6832
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275905325
Provider Name
Wayne Domalaon
Credential
Provider Entity Type
Individual
Gender
Male
Address
9000 W Wilderness Way Apt 32, Shreveport, LA, 71106-6832
Phone Number
318-675-9101
Fax Number
Provider Enumeration Date
10/28/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9000 W Wilderness Way Apt 32
City
Shreveport
State
Louisiana
Zip
71106-6832
Phone Number
318-675-9101
Fax Number
person
Provider Business Mailing Address Details
Address
9000 W Wilderness Way Apt 32
City
Shreveport
State
Louisiana
Zip
71106-6832
Phone Number
318-675-9101
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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