Individual
MALLORY ELIZABETH DAILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW, MSW
Contact information
Practice address
458 HERNDON ST, SHREVEPORT, LA 71101-4859
(318) 413-2990
Mailing address
458 HERNDON ST, SHREVEPORT, LA 71101-4859
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
17227
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
LA
Enumeration date
08/16/2022
Last updated
12/15/2022
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