Most Relevant Information
Provider Data
| NPI Number: | 1003328154 |
| Provider Name: | PATRICE A BEANER |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2017 |
| Last Updated: | 04/20/2018 |
Provider Practice Location
2800 YOUREE DR STE 482
SHREVEPORT
LA
711043666
Practice Location Phone/Fax
| Phone: | 3184559030 |
| Fax: |
Provider Mailing Location
431 ABILENE ST
SHREVEPORT
LA
711065027
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |