Individual
LANITA PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2924 KNIGHT ST STE 434, SHREVEPORT, LA 71105-2413
(318) 218-8704
Mailing address
2924 KNIGHT ST STE 434, SHREVEPORT, LA 71105-2413
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
11/29/2017
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