Individual
JESSICA L. LATIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
1545 LINE AVE, SHREVEPORT, LA 71101-4600
(318) 759-7865
Mailing address
3541 LAKESIDE DR, SHREVEPORT, LA 71119-6515
(318) 489-3095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC5981
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710083
—
LA
Enumeration date
09/15/2015
Last updated
01/17/2019
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