Individual
MR. KELVIN WAYNE LATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 JORDAN ST, SHREVEPORT, LA 71101-4518
(318) 208-8166
(318) 208-8430
Mailing address
6721 KENNEDY DR, SHREVEPORT, LA 71109-8329
(318) 404-4880
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/01/2017
Last updated
07/21/2022
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