Individual
SHARNELL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3021 SAMFORD AVE, SHREVEPORT, LA 71103-3834
(318) 469-4319
Mailing address
3021 SAMFORD AVE, SHREVEPORT, LA 71103-3834
(318) 469-4319
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007943858
LA
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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