Individual
JACQUILLA STEPHENS MOTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 N MARKET ST STE C104, SHREVEPORT, LA 71107
(318) 626-5597
(318) 626-5691
Mailing address
1500 N MARKET ST STE C104, SHREVEPORT, LA 71107-6545
(318) 626-5597
(318) 626-5691
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/27/2017
Last updated
07/31/2018
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