Individual
ASHLEY TANIYA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1543 GRIMMETT DR, SHREVEPORT, LA 71107
(318) 626-5597
(318) 626-5691
Mailing address
901 JONES ST, RUSTON, LA 71270-5841
(318) 497-3235
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
14944
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91282376
—
LA
Enumeration date
06/19/2018
Last updated
06/27/2018
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