Individual
SHAKEMA HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4348 S JEFFREY DR, BATON ROUGE, LA 70816-4196
(225) 361-0219
Mailing address
4348 S JEFFREY DR, BATON ROUGE, LA 70816-4196
(225) 361-0219
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012428457
DRIVER'S LICENSE
LA
Enumeration date
12/09/2019
Last updated
12/09/2019
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