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General NPI Number Information
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NPI Number | 1770225120
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Entity Type | Organization
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Legal Business Name | ARK-LA-TEX SOUND MINDS, LLC
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 11/19/2022
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Provider Practice Location Address
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Address Line | 2920 KNIGHT ST STE 102
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City | SHREVEPORT
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State | LA
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Zip | 71105-2412
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Country | US
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Telephone | 903-650-1155
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Fax | 318-374-6467
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Provider Business Mailing Address
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Address Line | PO BOX 921
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City | QUEEN CITY
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State | TX
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Zip | 75572-0921
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Country | US
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Telephone | 903-650-1155
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | LAURIE SMITH STIGER
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Credential | APRN
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Telephone | 903-650-1155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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