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Individual

SONTAVIA DEANN WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2715 MACKEY LN, SHREVEPORT, LA 71118-2556
(318) 617-9171
Mailing address
2402 PINEHURST BLVD, SHREVEPORT, LA 71104-3224

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/12/2021
Last updated
05/12/2021
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