Individual
TINA MARIE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
458 HERNDON ST, SHREVEPORT, LA 71101-4859
(318) 205-8989
Mailing address
458 HERNDON ST, SHREVEPORT, LA 71101-4859
(318) 205-8989
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
7573
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/17/2018
Last updated
06/14/2022
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