Provider Information for 1164693776
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Mrs. HAZEL CECILY RICHARDS LCSW
Sex: Female
NPI: 1164693776
Last Updated: 2023-09-18
Certification Date: 2023-09-18
Certification Date: 2023-09-18
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164693776 | ||||||||
| Enumeration Date | 2008-03-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 4992 SHREVEPORT, LA 71134-0992 United States Phone: 318-773-7326 | Fax:318-866-9622 | ||||||||
| Primary Practice Address | 510 E STONER AVE SHREVEPORT, LA 71101-4243 United States Phone: 318-221-8411 | Fax: | ||||||||
| Secondary Practice Address(es) | 432 OCKLEY DR | ||||||||
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