Individual
MS. SHALEATHA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 LINE AVE, SHREVEPORT, LA 71101-4612
(318) 677-3100
Mailing address
1800 LINE AVE, SHREVEPORT, LA 71101-4612
(318) 677-3100
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN156192
LA
Other
Enumeration date
07/08/2025
Last updated
07/09/2025
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