Individual
SATYAPRABHA REDDY BOLLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
820 JORDAN ST, SHREVEPORT, LA 71101-4518
(318) 458-7713
(318) 754-4195
Mailing address
820 JORDAN ST, SHREVEPORT, LA 71101-4518
(318) 458-7713
(318) 754-4195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5863
TX
101YP2500X
Professional Counselor
12182
TX
101YP2500X
Professional Counselor
Primary
4362
LA
106H00000X
Marriage & Family Therapist
1177
LA
106H00000X
Marriage & Family Therapist
4613
TX
Other
Enumeration date
06/06/2011
Last updated
12/04/2015
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