Individual
EVOL DATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6015 HEARNE AVE, SHREVEPORT, LA 71108
(318) 231-3090
Mailing address
6015 HEARNE AVE, SHREVEPORT, LA 71108-3803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC10396
LA
Other
Enumeration date
11/10/2015
Last updated
02/20/2025
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