Individual
DALE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5925 DEXTER PL, SHREVEPORT, LA 71129
(318) 286-8533
Mailing address
5925 DEXTER PL, SHREVEPORT, LA 71129-4909
(318) 286-8533
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/07/2017
Last updated
05/31/2018
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