Individual
ELIZABETH MAE FARGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
9441 STEVENS RD STE 150, SHREVEPORT, LA 71106-7574
(318) 947-9000
(318) 692-3904
Mailing address
128 CARROLL ST, SHREVEPORT, LA 71105-4235
(318) 230-0865
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-694
LA
Other
Enumeration date
09/25/2020
Last updated
01/24/2023
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