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1104356856
SHANNON JAVON SMITH
SHREVEPORT, LA
NPI
1104356856
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Other Name
SHANNON SMITH ASHLEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-06-15
Last Update Date
2017-06-15
Business Address
SHANNON JAVON SMITH
1717 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number: 318-226-9944
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Mailing Address
SHANNON JAVON SMITH
1785 HIGHWAY 162
BENTON, LA 71006-4528
Phone number: 318-272-5868
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