Individual
TERA RATTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SPRING ST STE 205, SHREVEPORT, LA 71101-3757
(318) 670-3170
Mailing address
800 SPRING ST STE 205, SHREVEPORT, LA 71101-3757
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PLC8868
LA
101YM0800X
Mental Health Counselor
PLC8868
LA
101YP2500X
Professional Counselor
Primary
8868
LA
171M00000X
Case Manager/Care Coordinator
PLC8868
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8868
LPC BOARD
LA
01
—
PLC8868
LPC BOARD
LA
Enumeration date
11/12/2015
Last updated
02/13/2024
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