Doctor Name: | MRS. MONA MURIEL QUALLS |
NPI Number: | 1871793935 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC |
License Number: | 3513 |
Business Practice Address: | 1002 Highland Ave Suite 300 Shreveport, LA - 711014143 |
Business Phone Number: | 3183647054 |
Business Fax Number: | 3187420763 |
Mailing Address: | 1002 Highland Ave, Suite 300 SHREVEPORT |
State: | LA |
Postal Code: | 711014143 |
Phone Number: | 3183647054 |
Fax Number: | 3187420763 |
NPI Enumeration Date: | 07/18/2007 |
NPI Last Update Date: | 07/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3513 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |