Individual
LATITIA RENEE MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
809 POLK ST, MANSFIELD, LA 71052-2452
(318) 621-0910
(318) 621-0918
Mailing address
702 WOODMONT PL, SHREVEPORT, LA 71108-5727
(318) 780-5501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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