Healthcare Provider Details

I. General information

NPI: 1740904291
Provider Name (Legal Business Name): LSUHSC-S SCHOOL OF ALLIED HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CLAIBORNE AVE
SHREVEPORT LA
71103-4204
US

IV. Provider business mailing address

1450 CLAIBORNE AVE
SHREVEPORT LA
71103-4204
US

V. Phone/Fax

Practice location:
  • Phone: 318-813-2972
  • Fax: 318-813-2975
Mailing address:
  • Phone: 318-813-2972
  • Fax: 318-813-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHARON L. DUNN
Title or Position: DEAN, SAHP
Credential: PT, PHD
Phone: 318-813-2901