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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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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