Individual
GEORGINA KATYUSCA MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 E 70TH ST STE A, SHREVEPORT, LA 71105-5363
(318) 227-4999
Mailing address
6900 BUNCOMBE RD LOT 51, SHREVEPORT, LA 71129-9496
(318) 553-0850
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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