Individual
MARJORIE LETARDE BOOTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
816 ONEONTA ST, SHREVEPORT, LA 71106-1130
(318) 550-7164
Mailing address
816 ONEONTA ST, SHREVEPORT, LA 71106-1130
(318) 550-7164
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6479
LA
1041C0700X
Clinical Social Worker
Primary
9301
SC
Other
Enumeration date
03/25/2008
Last updated
11/24/2009
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