Individual
KIMRON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
7550 PINES ROAD SUITE 1115, SHREVEPORT, LA 71129
(318) 683-4086
Mailing address
6014 ALYCIA NIKOLE LN, SHREVEPORT, LA 71129-4357
(318) 820-1985
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
LA
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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