Doctor Name: | LAURA ANNE DAVIS |
NPI Number: | 1255668034 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC |
License Number: | 3982 |
Business Practice Address: | 7607 Fern Ave Suite 202 Shreveport, LA - 711055739 |
Business Phone Number: | 3185641970 |
Business Fax Number: | 3188686670 |
Mailing Address: | 7607 Fern Ave, Suite 202 SHREVEPORT |
State: | LA |
Postal Code: | 711055739 |
Phone Number: | 3185641970 |
Fax Number: | 3188686670 |
NPI Enumeration Date: | 11/16/2009 |
NPI Last Update Date: | 11/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |