Individual
CLAIRE CONERLY MADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
(318) 222-3273
Mailing address
2000 FAIRFIELD AVE, SHREVEPORT, LA 71104-2002
(318) 222-8511
(318) 222-3273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3340
LA
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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