Individual
MARIANA PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
152 E COLLEGE ST, SHREVEPORT, LA 71104-2510
(225) 571-7323
Mailing address
152 E COLLEGE ST, SHREVEPORT, LA 71104-2510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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