Individual
NICOLE DEVONA WAHSINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 METAL STREET, SHREVEPORT, LA 71119
(318) 415-9889
Mailing address
2811 METAL ST, SHREVEPORT, LA 71103-2224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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