Organization
INNERLIGHT WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY BOOKER TRACY MS, LPC (OWNER)
(318) 268-0757
Entity
Organization
Contact information
Practice address
820 JORDAN ST, SUITE 204, SHREVEPORT, LA 71101-4518
(318) 267-0757
(318) 670-7232
Mailing address
1113 DREW LN, MINDEN, LA 71055-2301
(318) 268-0757
(318) 670-7232
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3699
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2185942
—
LA
Enumeration date
05/15/2016
Last updated
05/15/2016
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