Individual
RAINA W CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 YOUREE DR, SHREVEPORT, LA 71101-5117
(318) 675-0804
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 742-3408
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15474
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72-1307411
TAX ID
LA
Enumeration date
05/11/2016
Last updated
03/27/2023
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