Individual
MRS. KENETTA HERRIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3510 LINWOOD AVE, SHREVEPORT, LA 71103
(318) 636-4194
Mailing address
6009 FINANCIAL PLZ STE 105, SHREVEPORT, LA 71129-2615
(318) 670-8858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/09/2015
Last updated
05/15/2018
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