Doctor Name: | MRS. KRISTAL CLAYTON CHAMBERS |
NPI Number: | 1740558667 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4174 |
Business Practice Address: | 2912 Valley View Dr Shreveport, LA - 711084934 |
Business Phone Number: | 3185723354 |
Business Fax Number: | |
Mailing Address: | Po Box 8421, SHREVEPORT |
State: | LA |
Postal Code: | 711488421 |
Phone Number: | 3185723354 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2011 |
NPI Last Update Date: | 12/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4174 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |