Individual
LANA LYN TADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360
(318) 466-4646
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360
(318) 466-4646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW35170
ID
Other
Enumeration date
03/28/2016
Last updated
10/23/2024
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