Most Relevant Information
Provider Data
| NPI Number: | 1003353509 |
| Provider Name: | STEPHANIE SPELLS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/23/2017 |
| Last Updated: | 05/17/2018 |
Provider Practice Location
3510 LINWOOD AVE
SHREVEPORT
LA
711034512
Practice Location Phone/Fax
| Phone: | 3187734436 |
| Fax: |
Provider Mailing Location
3510 LINWOOD AVE
SHREVEPORT
LA
711034512
Provider Mailing Phone/Fax
| Phone: | 3187734436 |
| Fax: |