Individual
JENNIFER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3341 YOUREE DR STE 20A, SHREVEPORT, LA 71105-2149
(318) 425-2000
(318) 424-2601
Mailing address
3341 YOUREE DR STE 20A, SHREVEPORT, LA 71105-2149
(318) 425-2000
(318) 424-2601
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
35083
TX
103TC0700X
Clinical Psychologist
Primary
1399
LA
Other
Enumeration date
04/21/2014
Last updated
01/08/2020
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