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Individual

CARRIE J. WARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2605 BETTY ST, SHREVEPORT, LA 71108-5553
(318) 865-2311
(318) 865-2312
Mailing address
2605 BETTY ST, SHREVEPORT, LA 71108-5553
(501) 309-6361
(318) 865-2312

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1038610
LA
Enumeration date
07/23/2018
Last updated
04/09/2019
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