Doctor Name: | MR. CURTIS WAYNE SPEARS |
NPI Number: | 1699001602 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C. |
License Number: | 3768 |
Business Practice Address: | 6169 Greenwood Rd Shreveport, LA - 711198508 |
Business Phone Number: | 3183647800 |
Business Fax Number: | |
Mailing Address: | Po Box 53254, SHREVEPORT |
State: | LA |
Postal Code: | 711353254 |
Phone Number: | 3183647800 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2009 |
NPI Last Update Date: | 10/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3768 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |