Individual
DR. OCTAVIA LASHAWN LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3922
Mailing address
6453 LEADBETTER CT APT B, FORT POLK, LA 71459-8413
(214) 274-1713
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
UNLICENSED
AL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY26797
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2009
Last updated
07/07/2016
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