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General NPI Number Information
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NPI Number | 1558400085
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Entity Type | Individual
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Provider Name | ROBERT ELEC WARD M.S.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 2025 DESOTO ST
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City | SHREVEPORT
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State | LA
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Zip | 71103-4717
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Country | US
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Telephone | 318-550-0520
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Fax |
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Provider Business Mailing Address
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Address Line | 3817 PICKERING PASS DR
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City | BOSSIER CITY
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State | LA
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Zip | 71111-6422
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Country | US
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Telephone | 318-550-1896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4446
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License Number State | LA
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