Individual
SHANNON JAVON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 MARSHALL ST, SHREVEPORT, LA 71101-4139
(318) 226-9944
Mailing address
1785 HIGHWAY 162, BENTON, LA 71006-4528
(318) 272-5868
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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