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Individual

MS. DEQUETTA SANDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-S,LCDC,NCC,CCMHC

Contact information

Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
PO BOX 6538, SHREVEPORT, LA 71136-6538
(318) 946-3006

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11571
TX
101YM0800X
Mental Health Counselor
66783
TX
101YP2500X
Professional Counselor
Primary
66783
TX
101YP2500X
Professional Counselor
66873
TX
101YP2500X
Professional Counselor
8144
LA

Other

Enumeration date
10/21/2011
Last updated
11/22/2022
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