Individual
RICKI ALEXIS TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5720 S LAKESHORE DR APT 307, SHREVEPORT, LA 71119-3929
(913) 293-9437
Mailing address
5720 S LAKESHORE DR APT 307, SHREVEPORT, LA 71119-3929
(913) 293-9437
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
K03-71-2148
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K03-71-2148
—
KS
Enumeration date
08/09/2018
Last updated
08/09/2018
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