Individual
JUSTIN SLADE SPANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC
Contact information
Practice address
6564 MAIN ST, WINNSBORO, LA 71295-2701
(318) 435-7558
(318) 435-0480
Mailing address
6564 MAIN ST, WINNSBORO, LA 71295-2701
(318) 435-7558
(318) 435-0480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5056
LA
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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