| Molly Govener Phd Llc | |
|
820 Jordan St Ste 510f Shreveport LA 71101-4526 | |
| (318) 557-5519 | |
| Not Available |
| Full Name | Molly Govener Phd Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 820 Jordan St Ste 510f, Shreveport, Louisiana |
| Authorized Official Name and Position | Molly R. Boyd (OWNER) |
| Authorized Official Contact | 3185575519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Molly Govener Phd Llc 820 Jordan St Ste 510f Shreveport LA 71101-4526 Ph: (318) 557-5519 | Molly Govener Phd Llc 820 Jordan St Ste 510f Shreveport LA 71101-4526 Ph: (318) 557-5519 |
| NPI Number | 1528877362 |
|---|---|
| Provider Enumeration Date | 01/06/2025 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528877362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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