Individual
MRS. SHAWANDA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7871 WASSON RD, SHREVEPORT, LA 71107-8867
(318) 751-3990
Mailing address
6317 ERNWOOD CIR, SHREVEPORT, LA 71119-6204
(318) 218-5981
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
13051
LA
Other
Enumeration date
09/23/2015
Last updated
05/20/2024
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