Individual
LORETA T LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
9838 BALLANTRAE CIR, SHREVEPORT, LA 71106-7752
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5078
LA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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