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General NPI Number Information
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NPI Number | 1255375978
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Entity Type | Organization
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Legal Business Name | HELPING HANDS FOR COMMUNITY DEVELOPMENT, INC.
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2405 LINE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71104-3019
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Country | US
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Telephone | 318-227-1113
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Fax | 318-227-1119
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Provider Business Mailing Address
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Address Line | 2405 LINE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71104-3019
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Country | US
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Telephone | 318-227-1113
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Fax | 318-227-1119
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. KATRINA OBALETTE BODEN
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Credential | M.ED, CAT
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Telephone | 318-227-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 00194591
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License Number State | LA
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