Individual
VANITHA DORAIRAJAN KOTHAPALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 KINGS HWY, DEPT. OF PSYCHAITRY, SHREVEPORT, LA 71103-4228
(318) 675-6619
(318) 675-6148
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
300496
LA
Other
Enumeration date
04/09/2012
Last updated
06/06/2025
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