Individual
MICKEY DAWNELL LATHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13355
LA
1041C0700X
Clinical Social Worker
65844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65844
PRIVATE
TX
Enumeration date
05/05/2020
Last updated
09/13/2023
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