Individual
CAMRYN DENHAM-FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8501 MILLICENT WAY APT 1088, SHREVEPORT, LA 71115-2231
(225) 223-2620
Mailing address
8501 MILLICENT WAY APT 1088, SHREVEPORT, LA 71115-2231
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
7072
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/13/2017
Last updated
03/17/2025
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