Individual
ELLISA GLADNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 HILL ST, BOSSIER CITY, LA 71111-4121
(318) 505-1114
Mailing address
610 STOCKBRIDGE LN, SHREVEPORT, LA 71107-1951
(318) 393-3451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/01/2016
Last updated
09/14/2022
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