| Doctor Name: | JEANNE STREET |
| NPI Number: | 1033273107 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 342 |
| Business Practice Address: | 610 Herndon Ave Shreveport, LA - 71101 |
| Business Phone Number: | 3184243867 |
| Business Fax Number: | 3184245006 |
| Mailing Address: | 610 Herndon Ave, SHREVEPORT |
| State: | LA |
| Postal Code: | 71101 |
| Phone Number: | 3184243867 |
| Fax Number: | 3184245006 |
| NPI Enumeration Date: | 12/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |