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Individual

INDIA WITHERINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
525 ALEXANDER ST, JONESBORO, LA 71251-2001
(318) 259-4676
(318) 259-4677
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 259-4676

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1587
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
3333
LA
101YP2500X
Professional Counselor
Primary
6443
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1928756
LA
Enumeration date
06/30/2014
Last updated
02/04/2025
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