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General NPI Number Information
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NPI Number | 1891821641
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Entity Type | Organization
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Legal Business Name | INTERACTIONAL SERVICES, INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 707 SOUTHFIELD RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2219
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Country | US
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Telephone | 318-869-1632
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Fax | 318-869-1633
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Provider Business Mailing Address
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Address Line | 707 SOUTHFIELD RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2219
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Country | US
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Telephone | 318-869-1632
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Fax | 318-869-1633
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARGUERITE W SALLEY
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Credential | LCSW
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Telephone | 318-869-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 440B
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License Number State | LA
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