Individual
SHANTRECE COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTERS
Contact information
Practice address
1513 LINE AVE. SUITE 305, SHREVEPORT, LA 71101
(318) 208-8908
Mailing address
1513 LINE AVE. SUITE 305, SHREVEPORT, LA 71101
(318) 375-2781
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9240
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992278535
—
LA
Enumeration date
01/07/2019
Last updated
11/22/2024
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