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Individual

OLIVIA WILSON FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, NCC, CCTP

Contact information

Practice address
670 ALBEMARLE DR STE 1403, SHREVEPORT, LA 71106-5945
(318) 455-3965
Mailing address
8609 W WILDERNESS WAY, SHREVEPORT, LA 71106-6121
(318) 455-3965

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8365
LA

Other

Enumeration date
01/30/2024
Last updated
01/30/2024
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