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Individual

ASHLEY MICHELLE TERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHP

Contact information

Practice address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
Mailing address
2430 VANCEVILLE RD, BOSSIER CITY, LA 71111-6314
(319) 617-5349

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/25/2017
Last updated
07/25/2017
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