Provider Demographics
NPI:1134940745
Name:POLLARD, KIERRA (CIT)
Entity type:Individual
Prefix:
First Name:KIERRA
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9982 HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:LA
Mailing Address - Zip Code:71007-8719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7020 KLUG PINES RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3300
Practice Address - Country:US
Practice Address - Phone:318-683-4622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5760101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)