Individual
DEVIN JEANENE FAIRCLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8730 YOUREE DR STE B, SHREVEPORT, LA 71115-2518
(318) 227-9002
Mailing address
36 SHADY PINE LN, CONVERSE, LA 71419-3585
(318) 871-6910
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6340
LA
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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