Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | LA |
NPI | 1003264433 |
---|---|
Provider Name | David J Aubrey |
First Address | Shreveport, LA 71105-2415 |
Second Address | Shreveport, LA 71105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 16/05/2018 |