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Individual

MRS. KRISTAL BUTLER POLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
458 HERNDON ST, SHREVEPORT, LA 71101-4859
(318) 213-1860
(318) 213-1818
Mailing address
9434 CROOKED CREEK DR, SHREVEPORT, LA 71118-4155
(318) 332-2187

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC6466
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1417252230
VOLUNTEERS OF AMERICA NORTH LOUISIANA
LA
Enumeration date
10/04/2017
Last updated
06/30/2022
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