Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | A 443558 | LA |
NPI | 1073968764 |
---|---|
Provider Name | Michelle Cummings-Shelby |
First Address | Shreveport, LA 71106-5131 |
Second Address | Shreveport, LA 71106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2016 |
Last Update Date | 11/07/2019 |