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Individual

MRS. SHANNON HARPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A. CCCSLP

Contact information

Practice address
1615 WOLF CIR STE B, LAKE CHARLES, LA 70605
(337) 210-4242
Mailing address
810 E KADE LN, LAKE CHARLES, LA 70605-7197
(317) 331-6574
(337) 210-4244

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-188
LA
235Z00000X
Speech-Language Pathologist
22003466A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200710400 A
IN
Enumeration date
04/09/2007
Last updated
09/26/2018
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