Individual
KALAN JON WASHINGTON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. ED
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
(318) 862-3554
Mailing address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1760852511
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760852511
—
LA
Enumeration date
09/07/2017
Last updated
09/07/2017
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