Individual
JENNIFER NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
2285 BENTON RD STE D103, BOSSIER CITY, LA 71111-3465
(318) 584-7197
(318) 584-7080
Mailing address
8911 YOUREE DR, SHREVEPORT, LA 71115-3007
(318) 205-6691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5386
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/14/2020
Last updated
12/09/2021
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