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Individual

KENNA J LATIOLAIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
(318) 425-9670
Mailing address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
(318) 425-9670

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
685
LA

Other

Enumeration date
03/22/2021
Last updated
09/23/2025
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