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Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
Allied Health Clinics Early Steps
Organization subpart
No
Provider details
NPI number
Authorized official
REVA MATTHIEW ROBINSON MBA (DIRECTOR OF CLIN MGMT SYSTEM)
(318) 813-2962
Entity
Organization
Contact information
Practice address
1450 CLAIBORNE AVE, SHREVEPORT, LA 71103-4204
(318) 813-8296
(318) 813-2981
Mailing address
PO BOX 38933, SHREVEPORT, LA 71133-8933
(318) 813-2970
(318) 813-2975
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1884324
—
LA
Enumeration date
03/15/2010
Last updated
10/20/2020
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