Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1154820991 |
---|---|
Provider Name | Sheteisha Jones |
First Address | Bossier City, LA 71111-2042 |
Second Address | Bossier City, LA 71111-2042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2018 |
Last Update Date | 07/02/2018 |