Individual
MS. CHASTITY SHERMAINE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2620 CENTENARY BLVD STE 312, SHREVEPORT, LA 71104
(318) 681-9935
(318) 681-9938
Mailing address
3456 SAINT HELENS DR, SHREVEPORT, LA 71108-5351
(318) 946-4152
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
1962876250
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/24/2015
Last updated
11/20/2018
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