Individual
DEBRA KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 YOUREE DR, SHREVEPORT, LA 71101-5117
(318) 675-0804
(318) 425-9030
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 742-3408
(318) 841-1210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
07/02/2019
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