Provider Demographics
NPI:1003651860
Name:MAYS, RETRINA (PLPC)
Entity type:Individual
Prefix:
First Name:RETRINA
Middle Name:
Last Name:MAYS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 WESTRILEE DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-4350
Mailing Address - Country:US
Mailing Address - Phone:318-426-7399
Mailing Address - Fax:
Practice Address - Street 1:2611 BETTY ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-5521
Practice Address - Country:US
Practice Address - Phone:318-865-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC10083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health