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Individual

MRS. EARLINE MAYS CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSW

Contact information

Practice address
2219 CLAIBORNE AVE, SHREVEPORT, LA 71103-4301
(318) 779-0434
Mailing address
2219 CLAIBORNE AVE, SHREVEPORT, LA 71103-4301
(318) 779-0434

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LA

Other

Enumeration date
07/17/2023
Last updated
08/04/2023
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