Individual
CHARLETTE STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6022 FOX CHASE TRL, SHREVEPORT, LA 71129-3505
(318) 560-5351
Mailing address
6022 FOX CHASE TRL, SHREVEPORT, LA 71129-3505
(318) 560-5351
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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