Healthcare Provider Details

I. General information

NPI: 1518604412
Provider Name (Legal Business Name): SHONTELL MAGEE DOLLIOLE M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/13/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7541 DOGWOOD DR
NEW ORLEANS LA
70126-2007
US

IV. Provider business mailing address

7541 DOGWOOD DR
NEW ORLEANS LA
70126-2007
US

V. Phone/Fax

Practice location:
  • Phone: 504-356-1334
  • Fax:
Mailing address:
  • Phone: 504-356-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number6307
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: