Provider Demographics
NPI:1154937498
Name:BROWN, KASHONDRIA DEANJELIQUE (MHS)
Entity type:Individual
Prefix:
First Name:KASHONDRIA
Middle Name:DEANJELIQUE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 PINES RD STE 1115
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-3900
Mailing Address - Country:US
Mailing Address - Phone:318-683-4086
Mailing Address - Fax:318-683-4087
Practice Address - Street 1:7505 PINES RD STE 1100
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3900
Practice Address - Country:US
Practice Address - Phone:318-683-4086
Practice Address - Fax:318-683-4087
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health