Doctor Name: | MRS. CHELSIE PALLETT LIEGEY |
NPI Number: | 1215299680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CI |
License Number: | CI 5191 |
Business Practice Address: | 725 Jordan St Shreveport, LA - 711014615 |
Business Phone Number: | 3182211993 |
Business Fax Number: | |
Mailing Address: | Po Box 712, SHREVEPORT |
State: | LA |
Postal Code: | 711620712 |
Phone Number: | 3187548904 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2012 |
NPI Last Update Date: | 06/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CI 5191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |