Provider Demographics
NPI:1689188658
Name:GUESS, LA'DREAKA TERRELL
Entity Type:Individual
Prefix:
First Name:LA'DREAKA
Middle Name:TERRELL
Last Name:GUESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3671
Mailing Address - Country:US
Mailing Address - Phone:225-929-9738
Mailing Address - Fax:225-929-9740
Practice Address - Street 1:555 SAINT TAMMANY ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-929-9738
Practice Address - Fax:225-929-9740
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor