Individual
MIKAILAH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7330 FERN AVE STE 1103, SHREVEPORT, LA 71105-4989
(318) 606-5706
Mailing address
2220 DOVE HOLLOW DR, SHREVEPORT, LA 71118-5211
(318) 461-5294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-1003
LA
Other
Enumeration date
05/20/2019
Last updated
07/14/2025
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