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Mrs. Kywanna Shackelford, MA
Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana
NPI 1730616343

Kywanna Shackelford is a Student in an Organized Health Care Education/Training Program based in Shreveport, LA. Kywanna Shackelford practices in Shreveport, LA and has the professional credentials of MA. The NPI Number for Kywanna Shackelford is 1730616343 and holds a License No. (Louisiana).

The current practice location address for Kywanna Shackelford is 2920 Knight St, Shreveport, LA and can be reached out via phone at 918-670-7047 and via fax at 318-670-7156.

Location: 2920 Knight St, Shreveport, LA, 71105-2412
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730616343
Provider Name
Kywanna Shackelford
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
2920 Knight St, Shreveport, LA, 71105-2412
Phone Number
918-670-7047
Fax Number
318-670-7156
Provider Enumeration Date
05/12/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2920 Knight St
City
Shreveport
State
Louisiana
Zip
71105-2412
Phone Number
918-670-7047
Fax Number
318-670-7156
person
Provider Business Mailing Address Details
Address
2920 Knight St
City
Shreveport
State
Louisiana
Zip
71105-2412
Phone Number
918-670-7047
Fax Number
318-670-7156
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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