Individual
LONDON BLAIR VIDRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
690 SAN ANTONIO AVE, MANY, LA 71449-3015
(318) 256-5200
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
18341
LA
Other
Enumeration date
03/18/2024
Last updated
01/14/2025
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