Individual
EBONY CAPRICE BEAL-COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2920 KNIGHT ST STE 110, SHREVEPORT, LA 71105-2412
(318) 459-1600
(318) 861-2798
Mailing address
5324 HOLLYHOCK LN, BOSSIER CITY, LA 71112-4920
(318) 294-6712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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