Individual
FABIA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2921 SILVER PINE LN, SHREVEPORT, LA 71108-5545
(318) 573-1468
Mailing address
2921 SILVER PINE LN, SHREVEPORT, LA 71108-5545
(318) 573-1468
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/04/2022
Last updated
01/31/2023
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