Individual
ELLISE LATRYCE GARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1006 HIGHLAND AVE, SHREVEPORT, LA 71101-4103
(318) 678-7500
Mailing address
1006 HIGHLAND AVE, SHREVEPORT, LA 71101-4103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5478
LA
101YP2500X
Professional Counselor
Primary
5478
LA
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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