Provider Demographics
NPI:1770934630
Name:SPURS, ZA'KEEDRA
Entity type:Individual
Prefix:
First Name:ZA'KEEDRA
Middle Name:
Last Name:SPURS
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 1:27393 HIGHWAY 15 APT 111
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-3366
Mailing Address - Country:US
Mailing Address - Phone:601-870-1782
Mailing Address - Fax:
Practice Address - Street 1:775 S BONNER ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-5801
Practice Address - Country:US
Practice Address - Phone:318-254-7050
Practice Address - Fax:318-254-7053
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health