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Individual

TRYPHENA M JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
800 SPRING ST STE 215, SHREVEPORT, LA 71101-3757
(318) 344-7608
Mailing address
234 MAYO RD, SHREVEPORT, LA 71106-7916
(318) 344-7608

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
14253
LA
104100000X
Social Worker
Primary
14253
LA
1041C0700X
Clinical Social Worker
C006695
NC

Other

Enumeration date
01/12/2012
Last updated
07/26/2019
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