Provider Demographics
NPI:1982775300
Name:INABNET, ANN M (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:INABNET
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 LLOYD LN
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-4743
Mailing Address - Country:US
Mailing Address - Phone:318-219-7530
Mailing Address - Fax:
Practice Address - Street 1:1525 STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4705
Practice Address - Country:US
Practice Address - Phone:318-221-6121
Practice Address - Fax:318-222-7879
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1840OtherLPC
LA160OtherLMFT