Individual
KELLYE JEAN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
3821 SOUTHERN AVE, SHREVEPORT, LA 71106-1033
(318) 946-8157
Mailing address
108 COLIN P KELLY DR, MINDEN, LA 71055-7912
(318) 402-6379
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC6093
LA
Other
Enumeration date
11/21/2017
Last updated
11/21/2017
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