Individual
MRS. PAULETTE GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6811 FAIRFIELD AVE, SHREVEPORT, LA 71106-3803
(318) 216-5088
Mailing address
6811 FAIRFIELD AVE, SHREVEPORT, LA 71106-3803
(318) 216-5088
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600746614
—
LA
Enumeration date
02/24/2016
Last updated
02/24/2016
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