Individual
CHANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS
Contact information
Practice address
1513 LINE AVE, SUITE 315, SHREVEPORT, LA 71101-4621
(318) 221-2828
(318) 221-2998
Mailing address
1513 LINE AVE, SUITE 315, SHREVEPORT, LA 71101-4621
(318) 221-2828
(318) 221-2998
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/10/2016
Last updated
11/15/2016
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