Individual
KEERTHIGA RAVEENDRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
327327
LA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
327327
LA
Other
Enumeration date
07/26/2017
Last updated
06/14/2022
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