Individual
INA LYNETTE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6015 HEARNE AVE, SHREVEPORT, LA 71108-3803
(318) 213-1389
Mailing address
10512 KEYSBURG CT, SHREVEPORT, LA 71106-7786
(318) 470-1140
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7584
LA
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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