Individual
MRS. TRACY PURVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 361-8938
Mailing address
319 STANLEY FOMBY RD, SHONGALOO, LA 71072-2009
(985) 209-7150
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5120
LA
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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