person
Tracy Jerome Anderson
Mental Health Counselor in Shreveport, Louisiana
NPI 1962914424

Tracy Jerome Anderson is a Mental Health Counselor based in Shreveport, LA and is specialized in Mental Health. Tracy Jerome Anderson practices in Shreveport, LA. The NPI Number for Tracy Jerome Anderson is 1962914424 and holds a License No. (Louisiana).

The current practice location address for Tracy Jerome Anderson is 543 Stoner Ave, Shreveport, LA and can be reached out via phone at 318-673-9901 and via fax at 318-673-9904.

Location: 543 Stoner Ave, Shreveport, LA, 71108-5704
person
Provider Profile Details
NPI Number
1962914424
Provider Name
Tracy Jerome Anderson
Credential
Provider Entity Type
Individual
Gender
Male
Address
543 Stoner Ave, Shreveport, LA, 71108-5704
Phone Number
318-673-9901
Fax Number
318-673-9904
Provider Enumeration Date
10/24/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1147664 05 LA
institution
Provider Business Practice Location Address Details
Address
543 Stoner Ave
City
State
Zip
71101-4122
Phone Number
318-673-9901
Fax Number
318-673-9904
person
Provider Business Mailing Address Details
Address
543 Stoner Ave
City
State
Zip
71101-4122
Phone Number
318-673-9901
Fax Number
318-673-9904
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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