Individual
TAMRA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4650 LAKESHORE DR, APT 102, SHREVEPORT, LA 71109-2925
(318) 200-3315
Mailing address
4650 LAKESHORE DR, APT 102, SHREVEPORT, LA 71109-2925
(318) 200-3315
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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