Individual
NADIA MIMS WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
543 STONER AVE, SHREVEPORT, LA 71101-4122
(318) 673-9901
Mailing address
725 PICKWICK PL, SHREVEPORT, LA 71108-5718
(318) 364-9225
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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