Individual
EBONY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8938 TWELVE OAKS DR, SHREVEPORT, LA 71118
(318) 834-7437
Mailing address
8938 TWELVE OAKS DR, SHREVEPORT, LA 71118-2310
(318) 834-7437
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
07/19/2018
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