Individual
MR. LARRY LEE SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S
Contact information
Practice address
6015 HEARNE AVENUE, SHREVEPORT, LA 71108
(318) 210-7307
Mailing address
4827 RICE RD, SHREVEPORT, LA 71119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC9611
LA
101YP2500X
Professional Counselor
PLC9611
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/29/2015
Last updated
05/30/2024
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