Individual
MS. KERRI PATRICIA VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
6240 GREENWOOD RD, SHREVEPORT, LA 71119-8413
(318) 562-6320
(318) 855-8779
Mailing address
2651 BARRON RD LOT 412, KEITHVILLE, LA 71047-7353
(318) 510-6363
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5857
LA
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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