Individual
OLIVIA MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3825 GILBERT DR, SHREVEPORT, LA 71104-5000
(318) 408-1786
Mailing address
1002 CREOLE DR, BOSSIER CITY, LA 71111-8194
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9177
LA
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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