Individual
KEVON MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3511 YOUREE DR, SHREVEPORT, LA 71105-2119
(318) 861-8938
Mailing address
812 EDS BLVD, SHREVEPORT, LA 71107-2302
(318) 525-4978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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