Individual
STEPHANIE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 N MARKET ST, SHREVEPORT, LA 71107-6537
(318) 626-5597
Mailing address
717 TECUMSEH TRL, SHREVEPORT, LA 71107-5321
(318) 300-9991
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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