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Individual

SUSAN ING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
501 E STONER AVENUE, SHREVEPORT, LA 71101
(318) 221-8411
Mailing address
6012 PEPPERWOOD CIRCLE, BOSSIER CITY, LA 71111-5678
(318) 741-2431

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11343
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11343
MD LICENSE
HI
Enumeration date
08/09/2006
Last updated
07/08/2007
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