Individual provider · Type 1 NPI

Larry Colenzo Wilson

Mental Health Counselor · Shreveport, LA

NPI number 1750869285 Active

Practice location

6224 N Inwood Rd
Shreveport, LA 71119-7213

Call (318) 453-0447 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1750869285

Larry Colenzo Wilson's National Provider Identifier is 1750869285, issued on Aug 6, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Shreveport, LA. The record was last updated on Aug 6, 2018.