Individual
SHANEEKA DESHA MOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 590-8000
Mailing address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
113166
TX
104100000X
Social Worker
18320
LA
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/02/2021
Last updated
06/22/2025
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