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General NPI Number Information
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NPI Number | 1912426057
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Entity Type | Individual
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Provider Name | GREGORY GREER LAC
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Gender | Male
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 208 COLE AVE STE 6
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City | MONROE
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State | LA
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Zip | 71203-3814
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Country | US
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Telephone | 318-366-2553
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Fax |
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Provider Business Mailing Address
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Address Line | 147 OLEANDER DR
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City | WEST MONROE
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State | LA
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Zip | 71291-9452
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Country | US
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Telephone | 318-366-2553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1554
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License Number State | LA
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