Individual
MS. AMANDA MARIE MOUSHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2620 CENTENARY BLVD, BUILDING 3, SUITE 312, SHREVEPORT, LA 71104-3356
(318) 681-9935
(318) 681-9938
Mailing address
3650 GREENWAY PL, SHREVEPORT, LA 71105-2012
(318) 469-0053
(318) 681-9938
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4017
LA
101YP2500X
Professional Counselor
Primary
4017
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4017
LICENSED PROFESSIONAL COUNSELOR
LA
Enumeration date
02/06/2012
Last updated
02/06/2012
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