Individual
DICKIE M. TRAVINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
527 CROCKETT ST, SHREVEPORT, LA 71101-3601
(318) 222-8511
(318) 317-3333
Mailing address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
(318) 317-3333
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
OBHPSS1038
LA
Other
Enumeration date
05/30/2024
Last updated
07/25/2024
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