Individual
DARREN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3939 LINWOOD AVE, SHREVEPORT, LA 71108-2415
(318) 868-3093
Mailing address
3730 FAIRFIELD AVE UNIT B, SHREVEPORT, LA 71104-4738
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813288219
—
LA
Enumeration date
08/10/2018
Last updated
02/25/2021
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