Individual
MS. AMY MATHEWS CREEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
(318) 676-5077
Mailing address
8674 JACKSON SQUARE PL, SHREVEPORT, LA 71115-2726
(318) 798-9266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2402
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8686
OMH PROVIDER NUMBER
LA
Enumeration date
01/19/2007
Last updated
07/08/2007
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