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Individual

STACY CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LMT, BCCS

Contact information

Practice address
1534 ELIZABETH AVE STE 401, SHREVEPORT, LA 71101-4531
(318) 464-5148
Mailing address
2971 SLIGO RD, HAUGHTON, LA 71037-7605
(318) 464-5148

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10024
LA
247200000X
Other Technician

Other

Enumeration date
04/25/2024
Last updated
06/05/2025
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