Individual
LACYNTHIA DEWHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 W 79TH ST, SHREVEPORT, LA 71106-4819
(318) 688-8190
Mailing address
351 W 79TH ST, SHREVEPORT, LA 71106-4819
(318) 688-8190
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
07/21/2022
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