Provider Demographics
NPI:1285699975
Name:DUHON, AUDRA ELIZABETH (MED, LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:AUDRA
Middle Name:ELIZABETH
Last Name:DUHON
Suffix:
Gender:F
Credentials:MED, LPC, LMFT
Other - Prefix:MS
Other - First Name:AUDRA
Other - Middle Name:STINSON
Other - Last Name:DUHON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LPC, LMFT
Mailing Address - Street 1:6121 FERN AVE
Mailing Address - Street 2:27
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4151
Mailing Address - Country:US
Mailing Address - Phone:318-797-6519
Mailing Address - Fax:
Practice Address - Street 1:910 PIERREMONT RD
Practice Address - Street 2:SUITE 251
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2069
Practice Address - Country:US
Practice Address - Phone:318-869-4700
Practice Address - Fax:318-869-4716
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3116101YP2500X
LA436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist