Individual
ROSS GITHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC 1144
Contact information
Practice address
520 OLIVE ST, SHREVEPORT, LA 71104-2312
(318) 459-8922
Mailing address
6129 RIVER RD, SHREVEPORT, LA 71105-4833
(318) 459-8922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1144
LA
Other
Enumeration date
09/26/2007
Last updated
03/17/2018
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