person
Corey Glen White
Mental Health Clinic/Center (Including Community Mental Health Center) in Shreveport, Louisiana
NPI 1891557203

Corey Glen White is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Shreveport, LA and is specialized in Mental Health (Including Community Mental Health Center). Corey Glen White practices in Shreveport, LA. The NPI Number for Corey Glen White is 1891557203 and holds a License No. (Louisiana).

The current practice location address for Corey Glen White is 404 Hearne Ave, Shreveport, LA and can be reached out via phone at 318-716-1369 and via fax at 318-675-0120.

Location: 404 Hearne Ave, Shreveport, LA, 71103-2022
person
Provider Profile Details
NPI Number
1891557203
Provider Name
Corey Glen White
Credential
Provider Entity Type
Individual
Gender
Male
Address
404 Hearne Ave, Shreveport, LA, 71103-2022
Phone Number
318-716-1369
Fax Number
318-675-0120
Provider Enumeration Date
01/30/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
404 Hearne Ave
City
State
Zip
71103-2022
Phone Number
318-716-1369
Fax Number
318-675-0120
person
Provider Business Mailing Address Details
Address
404 Hearne Ave
City
State
Zip
71103-2022
Phone Number
318-716-1369
Fax Number
318-675-0120
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
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