White, Corey Glen
White, Corey Glen is an sole proprietor health care provider with primary practice located at 404 Hearne Ave , Shreveport LA 71103-2022. He recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as his primary health care specialty. White, Corey Glen can be contacted via phone (318) 716-1369.Contact Information
Primary practice address
404 Hearne Ave
Shreveport LA 71103-2022
Phone: (318) 716-1369
Fax: (318) 675-0120
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X |
Profile Details
| NPI number | 1891557203 |
|---|---|
| LBN Legal business name | White, Corey Glen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2024 |
| Last updated | Jan 30th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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