Individual
ERICA BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1513 LINE AVE, SUITE 315, SHREVEPORT, LA 71101
(318) 221-2828
(318) 221-2998
Mailing address
1513 LINE AVE, SUITE 315, SHREVEPORT, LA 71101-4621
(318) 221-2828
(318) 221-2998
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/30/2016
Last updated
05/17/2018
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